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General NPI Number Information
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NPI Number | 1518907880
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Entity Type | Individual
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Provider Name | LUIS B MARRERO MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 23 KENNEDY ST SUITE 302
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City | BRADFORD
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State | PA
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Zip | 16701-2005
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Country | US
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Telephone | 814-362-9804
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Fax | 814-362-6571
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Provider Business Mailing Address
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Address Line | 7 ACEE DRIVE
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City | NATRONA HEIGHTS
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State | PA
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Zip | 15065
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Country | US
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Telephone | 800-223-5544
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Fax | 724-294-3206
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD035910E
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License Number State | PA
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