Healthcare Provider Details

I. General information

NPI: 1700852423
Provider Name (Legal Business Name): ROBERT A MARWICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9229 UNIVERSITY BLVD SUITE E
NORTH CHARLESTON SC
29406-9150
US

IV. Provider business mailing address

9229 UNIVERSITY BLVD SUITE E
NORTH CHARLESTON SC
29406-9150
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-2721
  • Fax: 843-797-0271
Mailing address:
  • Phone: 843-797-2721
  • Fax: 843-797-0271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number6917
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: