Provider Demographics
NPI:1588654891
Name:MARASCO, WILLIAM JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAMES
Last Name:MARASCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 AARONS WAY
Mailing Address - Street 2:
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673-2593
Mailing Address - Country:US
Mailing Address - Phone:508-771-5200
Mailing Address - Fax:
Practice Address - Street 1:21 AARONS WAY
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673-2593
Practice Address - Country:US
Practice Address - Phone:508-771-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA713112085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA760277OtherTUFTS HEALTH PLAN
MAJ16021OtherBCBS MA
MA3135942Medicaid
MA760277OtherTUFTS HEALTH PLAN