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NPI Code Detail

MEDICARE: ROSS MARNOCK DO

MEDICARE:   ROSS  MARNOCK  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
1207Q00000XFamily Medicine PhysicianLL92472SC
2208D00000XGeneral Practice Physician92472SC

General Provider Information

NPI Number : 1154165488
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSS MARNOCK DO
Provider Business Mailing Address
First Line : 169 ASHLEY AVENUIE ROOM 202 MAIN HOSPITAL MSC 333
Second Line :
City : CHARLESTON
State : SC
Zip : 29425-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 650 ELLIS OAK DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29412-3089
Country : US
Telephone Number : 843-876-7080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2024
Last Update Date : 12/08/2025

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Directions to “ ROSS MARNOCK DO” Practice Location

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