Healthcare Provider Details

I. General information

NPI: 1538007653
Provider Name (Legal Business Name): NANNETTE MORALES-MARIETTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 SUNSET CT STE 100
WEST COLUMBIA SC
29169-2464
US

IV. Provider business mailing address

145 SUNSET CT STE 100
WEST COLUMBIA SC
29169-2464
US

V. Phone/Fax

Practice location:
  • Phone: 803-314-5494
  • Fax: 803-739-3546
Mailing address:
  • Phone: 803-314-5494
  • Fax: 803-739-3546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: