Provider Demographics
NPI:1598712531
Name:MARONE, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:MARONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:707 WHITE HORSE RD
Mailing Address - Street 2:SUITE C105
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2461
Mailing Address - Country:US
Mailing Address - Phone:856-309-9700
Mailing Address - Fax:856-309-9192
Practice Address - Street 1:707 WHITE HORSE RD
Practice Address - Street 2:SUITE C105
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2461
Practice Address - Country:US
Practice Address - Phone:856-309-9700
Practice Address - Fax:856-309-9192
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02358700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2239809Medicaid
NJ141123Medicare PIN
NJC53509Medicare UPIN