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NPI Code Detail

MEDICARE: VINCENT MARINO DO

MEDICARE: VINCENT MARINO DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician34007842OH
2207Q00000XFamily Medicine Physician34007842OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093791691
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCENT MARINO DO
Provider Business Mailing Address
First Line : 107 ROYAL BIRKDALE DR
Second Line : SUITE A
City : COLUMBIANA
State : OH
Zip : 44408-8493
Country : US
Telephone Number : 330-482-9350
Fax Number : 330-482-5695
Provider Business Practice Location Address
First Line : 107 ROYAL BIRKDALE DR
Second Line : SUITE A
City : COLUMBIANA
State : OH
Zip : 44408-8493
Country : US
Telephone Number : 330-482-9350
Fax Number : 330-482-5695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2005
Last Update Date : 02/08/2012

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Directions to “ VINCENT MARINO DO” Practice Location

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