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NPI Code Detail

MEDICARE: DR. ANNA V MARINO MD

MEDICARE: DR. ANNA V MARINO 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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician43442KY
2207R00000XInternal Medicine Physician43442KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124217260
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNA V MARINO MD
Provider Business Mailing Address
First Line : PO BOX 910670
Second Line :
City : LEXINGTON
State : KY
Zip : 40591-0670
Country : US
Telephone Number : 859-971-4685
Fax Number : 859-971-4601
Provider Business Practice Location Address
First Line : 3084 LAKECREST CIR
Second Line :
City : LEXINGTON
State : KY
Zip : 40513-1706
Country : US
Telephone Number : 859-219-6440
Fax Number : 859-219-6449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2007
Last Update Date : 12/09/2020

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