MEDICARE: DR. SCOTT ANTHONY MARINELLI DO

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	207P00000X	Emergency Medicine Physician		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	133MP	OTHER	NC	BCBS OF NC GROUP #015CK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144220856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ANTHONY MARINELLI DO

Provider Business Mailing Address
First Line	:	5346 CLUBHOUSE LN
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-9794
Country	:	US
Telephone Number	:	910-483-2448
Fax Number	:

Provider Business Practice Location Address
First Line	:	5346 CLUBHOUSE LN
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-9794
Country	:	US
Telephone Number	:	910-483-2448
Fax Number	:

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	07/09/2007

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