Provider Demographics
NPI:1437689411
Name:ARANDA, MARCOS
Entity Type:Individual
Prefix:
First Name:MARCOS
Middle Name:
Last Name:ARANDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EAST HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:706-787-1745
Practice Address - Street 1:GENERAL SURGERY, EISENHOWER ARMY MEDICAL CENTER
Practice Address - Street 2:300 EAST HOSPITAL ROAD
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-787-1745
Practice Address - Fax:706-787-1745
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC91494208600000X
GA80806171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208600000XAllopathic & Osteopathic PhysiciansSurgery