Provider Demographics
NPI:1548302227
Name:MARKS, AMY LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
Last Name:MARKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1122 KENILWORTH DR STE 317
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2146
Mailing Address - Country:US
Mailing Address - Phone:410-296-4616
Mailing Address - Fax:410-337-5068
Practice Address - Street 1:6701 N CHARLES ST STE 4226
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:410-296-4616
Practice Address - Fax:410-337-5068
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301503218207L00000X
VA0101247292207L00000X
MDD0065788207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD412901600Medicaid
MDR228Medicare PIN
MDCA8702Medicare PIN