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NPI Code Detail

MEDICARE: RONALD F MARASCALCO PA-C

MEDICARE:   RONALD F MARASCALCO  PA-C
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
1363A00000XPhysician Assistant0010-00908NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2NCL847BOTHERNCMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1587607142OTHERMSBCBS

General Provider Information

NPI Number : 1649389651
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD F MARASCALCO PA-C
Provider Business Mailing Address
First Line : 1806 GLENDALE DR SW
Second Line :
City : WILSON
State : NC
Zip : 27893-4402
Country : US
Telephone Number : 800-243-0566
Fax Number : 800-243-0566
Provider Business Practice Location Address
First Line : 1806 GLENDALE DR SW
Second Line :
City : WILSON
State : NC
Zip : 27893-4402
Country : US
Telephone Number : 800-243-0566
Fax Number : 252-243-1347
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 02/20/2020

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Directions to “ RONALD F MARASCALCO PA-C” Practice Location

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