Provider Demographics
NPI:1003873654
Name:MARZLUFF, JOSEPH M (MDFACS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:MARZLUFF
Suffix:
Gender:M
Credentials:MDFACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9313 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:N CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-7140
Mailing Address - Country:US
Mailing Address - Phone:843-553-7615
Mailing Address - Fax:843-553-1008
Practice Address - Street 1:9313 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 305
Practice Address - City:N CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-7140
Practice Address - Country:US
Practice Address - Phone:843-553-7615
Practice Address - Fax:843-553-1008
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC7361207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC073618Medicaid
SC570832069OtherTAX ID
SCB921260281Medicare ID - Type Unspecified
SC073618Medicaid
SCB92126Medicare UPIN