Provider Demographics
NPI:1164414181
Name:MARRONE, GARY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:CHARLES
Last Name:MARRONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:740 E STATE ST
Mailing Address - Street 2:CARDIOTHORACIC SURGICAL SPECIALISTS SRHS
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-3328
Mailing Address - Country:US
Mailing Address - Phone:724-983-7200
Mailing Address - Fax:724-983-7210
Practice Address - Street 1:740 E STATE ST
Practice Address - Street 2:CARDIOTHORACIC SURGICAL SPECIALISTS SRHS
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3328
Practice Address - Country:US
Practice Address - Phone:724-983-7200
Practice Address - Fax:724-983-7210
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD044216E208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE52832Medicare UPIN