Healthcare Provider Details

I. General information

NPI: 1588649446
Provider Name (Legal Business Name): JAMES PAUL MARRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 05/27/2024
Certification Date: 05/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 SAINT MATTHEWS RD
ORANGEBURG SC
29118-1442
US

IV. Provider business mailing address

3000 SAINT MATTHEWS RD
ORANGEBURG SC
29118-1442
US

V. Phone/Fax

Practice location:
  • Phone: 803-395-3837
  • Fax:
Mailing address:
  • Phone: 803-395-3837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number19837
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: