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1427262765

NPI Code Detail

MEDICARE: MEHRETTE M MARU MD

MEDICARE: MEHRETTE M MARU 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	207RI0011X	Interventional Cardiology Physician	22808	WV
2	390200000X	Student in an Organized Health Care Education/Training Program

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00848497	OTHER		MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1427262765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEHRETTE M MARU MD

Provider Business Mailing Address
First Line	:	PO BOX 1680
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25717-1680
Country	:	US
Telephone Number	:	304-697-1396
Fax Number	:

Provider Business Practice Location Address
First Line	:	4270 US ROUTE 60
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25705-2936
Country	:	US
Telephone Number	:	304-781-3610
Fax Number	:	304-781-3611

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	09/03/2025

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Directions to “ MEHRETTE M MARU MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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