Provider Demographics
NPI:1922044221
Name:SUBIK, MARC A (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:A
Last Name:SUBIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-886-9403
Mailing Address - Fax:740-446-5153
Practice Address - Street 1:3100 MACCORKLE AVE SE
Practice Address - Street 2:STE 509
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1226
Practice Address - Country:US
Practice Address - Phone:304-342-0821
Practice Address - Fax:304-345-6679
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV12349207RG0100X
OH35-04-6808207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00150213OtherRR MEDICARE
000000347087OtherANTHEM BCBS
001714179OtherMOUNTAIN STATE BCBS
OH000000185211OtherUNISON MEDICAID
OH0469238OtherMOLINA MEDICAID
WV0083470000Medicaid
OH310917085157OtherCARESOURCE MEDICAID
OH310917085157OtherCARESOURCE MEDICAID
P00150213OtherRR MEDICARE
WV0502714Medicare PIN