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NPI Code Detail

MEDICARE: DR. JOHN R MARINO SR. DPM

MEDICARE: DR. JOHN R MARINO SR. DPM
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
1213ES0131XFoot Surgery Podiatrist131SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00832519OTHERSCRAILROAD MEDICARE ID-RSFPN

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 : 1346240579
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN R MARINO SR. DPM
Provider Business Mailing Address
First Line : PO BOX 751649
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1649
Country : US
Telephone Number : 843-789-1620
Fax Number : 843-724-2440
Provider Business Practice Location Address
First Line : 3510 HIGHWAY 17 BYP N STE 220
Second Line :
City : MT PLEASANT
State : SC
Zip : 29466-8245
Country : US
Telephone Number : 843-853-3474
Fax Number : 843-853-3500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 01/28/2019

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Directions to “ DR. JOHN R MARINO SR. DPM” Practice Location

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