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General NPI Number Information
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NPI Number | 1477680114
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Entity Type | Individual
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Provider Name | MARC A JEROME MD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 184 RUBY PLAZA
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City | CHRISTIANSTED
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State | VI
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Zip | 00820
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Country | US
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Telephone | 340-778-5777
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Fax | 340-778-3161
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Provider Business Mailing Address
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Address Line | PO BOX 25537
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City | CHRISTIANSTED
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State | VI
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Zip | 00824-1537
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Country | US
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Telephone | 340-713-9002
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Fax | 340-713-0215
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 1041
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License Number State | VI
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