Provider Demographics
NPI:1225078926
Name:WILLIAM J MARASCO MD PC
Entity Type:Organization
Organization Name:WILLIAM J MARASCO MD PC
Other - Org Name:CAPE DIAGNSOTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARASCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-771-5200
Mailing Address - Street 1:21 AARONS WAY
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673
Mailing Address - Country:US
Mailing Address - Phone:508-771-5200
Mailing Address - Fax:508-771-5202
Practice Address - Street 1:21 AARONS WAY
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673
Practice Address - Country:US
Practice Address - Phone:508-771-5200
Practice Address - Fax:508-771-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAWIM17523OtherBLUE CROSS BLUE SHIELD
MA3135942Medicaid
MAWIM17523OtherBLUE CROSS BLUE SHIELD