Provider Demographics
NPI:1639450778
Name:MARCHIOLI, MARC EDWARD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:EDWARD
Last Name:MARCHIOLI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4 ALLEGHENY CTR FL 7
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5255
Mailing Address - Country:US
Mailing Address - Phone:412-330-5851
Mailing Address - Fax:412-330-5844
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-6413
Practice Address - Fax:407-303-6414
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA965208M00000X, 207RC0200X
MI5601010961363A00000X
NY023516363AM0700X
PAMA055058363AM0700X
MAPA-TF-0188363A00000X
FLPA9106961363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA055058OtherPA STATE LICENSE
GA965OtherGA STATE LICENSE
FLPA9106961OtherFL STATE LICENSE