Provider Demographics
NPI:1609875244
Name:MARTURANO, JO (MD)
Entity Type:Individual
Prefix:DR
First Name:JO
Middle Name:
Last Name:MARTURANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W. CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8301
Mailing Address - Country:US
Mailing Address - Phone:803-359-9419
Mailing Address - Fax:803-254-9740
Practice Address - Street 1:GRC
Practice Address - Street 2:7520 MONTICELLO RD
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-254-3313
Practice Address - Fax:803-254-9740
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-16
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC124652084P0800X
SCSC124652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCC68823Medicare UPIN