Provider Demographics
NPI:1629234463
Name:MARATH, BIJU (MD)
Entity Type:Individual
Prefix:DR
First Name:BIJU
Middle Name:
Last Name:MARATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4300B W RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2568
Mailing Address - Country:US
Mailing Address - Phone:228-863-7393
Mailing Address - Fax:228-863-0546
Practice Address - Street 1:4300 W RAILROAD ST
Practice Address - Street 2:SUITE B
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501
Practice Address - Country:US
Practice Address - Phone:228-863-7393
Practice Address - Fax:228-863-0546
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS22003207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology