MEDICARE: DR. MARK A MARIEB M.D.

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	207RC0000X	Cardiovascular Disease Physician	28115	CT
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	028115	CT
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	2022-00622	NC
4	207RC0000X	Cardiovascular Disease Physician	2022-00622	NC

General Provider Information

NPI Number	:	1508862632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A MARIEB M.D.

Provider Business Mailing Address
First Line	:	810 FAIRGROVE CHURCH RD
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-9617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3521 GRAYSTONE PL SE STE 202
Second Line	:
City	:	CONOVER
State	:	NC
Zip	:	28613-8269
Country	:	US
Telephone Number	:	828-732-5700
Fax Number	:

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	02/17/2026

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