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General NPI Number Information
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NPI Number | 1427030949
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Entity Type | Individual
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Provider Name | ROBERT C MARCIANO DO
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 1309 10TH AVE W
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City | MOBRIDGE
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State | SD
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Zip | 57601-1146
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Country | US
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Telephone | 605-845-3692
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Fax | 605-845-8252
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Provider Business Mailing Address
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Address Line | 1309 10TH AVE W
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City | MOBRIDGE
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State | SD
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Zip | 57601-1146
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Country | US
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Telephone | 605-845-3692
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Fax | 605-845-8252
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4891
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License Number State | SD
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