Provider Demographics
NPI:1144545799
Name:MARX, GRACE ELLEN (MD)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ELLEN
Last Name:MARX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3839
Mailing Address - Country:US
Mailing Address - Phone:206-214-6103
Mailing Address - Fax:
Practice Address - Street 1:605 BANNOCK ST
Practice Address - Street 2:MC 2600
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4505
Practice Address - Country:US
Practice Address - Phone:303-602-8736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52448207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease