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NPI Code Detail

MEDICARE: THOMAS PAUL MARCOTTE CRNA

MEDICARE: THOMAS PAUL MARCOTTE CRNA
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
1367500000XCertified Registered Nurse AnesthetistAPN2122SC

Other Identifiers

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

General Provider Information

NPI Number : 1487637989
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS PAUL MARCOTTE CRNA
Provider Business Mailing Address
First Line : 1 INDEPENDENCE PT
Second Line : SUITE 212
City : GREENVILLE
State : SC
Zip : 29615-4545
Country : US
Telephone Number : 864-797-6400
Fax Number :
Provider Business Practice Location Address
First Line : 298 MEMORIAL DR
Second Line :
City : SENECA
State : SC
Zip : 29672-9443
Country : US
Telephone Number : 864-882-3351
Fax Number : 864-885-7619
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 06/15/2015

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Directions to “ THOMAS PAUL MARCOTTE CRNA” Practice Location

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