MEDICARE: KARL MARETH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	92309	GA
2	207R00000X	Internal Medicine Physician	ME134605	FL
3	207RG0100X	Gastroenterology Physician	34875	OK

General Provider Information

NPI Number	:	1083061808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL MARETH MD

Provider Business Mailing Address
First Line	:	3280 HOWELL MILL RD NW # T-100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-4111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	134 MOUNTAINSIDE VILLAGE PKWY BLDG 500
Second Line	:
City	:	JASPER
State	:	GA
Zip	:	30143-8694
Country	:	US
Telephone Number	:	706-253-7340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2016
Last Update Date	:	01/12/2024

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