Healthcare Provider Details

I. General information

NPI: 1760894083
Provider Name (Legal Business Name): MARC SCIARRA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 IVEY LN STE B
PINEHURST NC
28374-9817
US

IV. Provider business mailing address

150 IVEY LN STE B
PINEHURST NC
28374-9817
US

V. Phone/Fax

Practice location:
  • Phone: 910-215-5210
  • Fax: 910-235-7988
Mailing address:
  • Phone: 910-215-5210
  • Fax: 910-235-7988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200473
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: