Provider Demographics
NPI:1114958014
Name:MAROTTA, DAVID (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MAROTTA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2913
Mailing Address - Country:US
Mailing Address - Phone:256-401-4606
Mailing Address - Fax:256-401-4603
Practice Address - Street 1:110 S ANNISTON AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2961
Practice Address - Country:US
Practice Address - Phone:256-207-0200
Practice Address - Fax:256-207-0209
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000000716208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery