Healthcare Provider Details

I. General information

NPI: 1811951551
Provider Name (Legal Business Name): PAUL L MARZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 STATION AVE
SOUTH YARMOUTH MA
02664
US

IV. Provider business mailing address

237 STATION AVE
SOUTH YARMOUTH MA
02664
US

V. Phone/Fax

Practice location:
  • Phone: 508-394-2116
  • Fax: 508-760-1919
Mailing address:
  • Phone: 508-394-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number72179
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: