MEDICARE: SARAH TAUNTON 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
1	207R00000X	Internal Medicine Physician	XXXXXXXXX	TX
2	390200000X	Student in an Organized Health Care Education/Training Program
3	208M00000X	Hospitalist Physician	S2914	TX

General Provider Information

NPI Number	:	1326493081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH TAUNTON MARINO MD

Provider Business Mailing Address
First Line	:	PO BOX 163441
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78716-3441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5656 BEE CAVES RD
Second Line	:	BLDG C STE. 101
City	:	AUSTIN
State	:	TX
Zip	:	78746-7874
Country	:	US
Telephone Number	:	512-323-5465
Fax Number	:	512-327-1390

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

Provider Enumeration Date	:	05/02/2016
Last Update Date	:	05/21/2020

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