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General NPI Number Information
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NPI Number | 1104857796
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Entity Type | Individual
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Provider Name | JUSTIN JOHN MARONE D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1457 NORTH M-52
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City | OWOSSO
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State | MI
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Zip | 48864
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Country | US
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Telephone | 989-725-8436
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Fax | 989-723-8164
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Provider Business Mailing Address
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Address Line | P. BOX 1079
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City | OWOSSO
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State | MI
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Zip | 48867
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Country | US
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Telephone | 989-725-8436
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Fax | 989-723-8164
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | JM012360
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | JM012360
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License Number State | MI
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