Provider Demographics
NPI:1548521461
Name:MARKUS, JOHNATHON TOMA (MD)
Entity type:Individual
Prefix:DR
First Name:JOHNATHON
Middle Name:TOMA
Last Name:MARKUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 RHINE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-3065
Mailing Address - Country:US
Mailing Address - Phone:248-892-4675
Mailing Address - Fax:
Practice Address - Street 1:37399 GARFIELD RD STE 104
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-3672
Practice Address - Country:US
Practice Address - Phone:586-569-3379
Practice Address - Fax:586-576-6264
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301106661208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program