Healthcare Provider Details

I. General information

NPI: 1437117603
Provider Name (Legal Business Name): MARCO CIOPPI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SIVLEY RD SW STE 305
HUNTSVILLE AL
35801
US

IV. Provider business mailing address

201 SIVLEY RD SW STE 305
HUNTSVILLE AL
35801
US

V. Phone/Fax

Practice location:
  • Phone: 256-536-9000
  • Fax: 256-265-6912
Mailing address:
  • Phone: 256-536-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number24102
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: