Provider Demographics
NPI:1730217928
Name:MARCUM, STEPHEN CRAIG (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CRAIG
Last Name:MARCUM
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 1:1015 W MEDICAL CENTER BLVD STE 1400
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4055
Mailing Address - Country:US
Mailing Address - Phone:281-338-2861
Mailing Address - Fax:281-554-2035
Practice Address - Street 1:1015 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 1400
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4052
Practice Address - Country:US
Practice Address - Phone:281-338-2861
Practice Address - Fax:281-554-2035
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9983207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131764607Medicaid
TX8F0811Medicare ID - Type Unspecified