Provider Demographics
NPI:1639497829
Name:MARINO, MATTHEW ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ANTHONY
Last Name:MARINO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:226 S WOODS MILL RD
Mailing Address - Street 2:37W
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3662
Mailing Address - Country:US
Mailing Address - Phone:314-523-5300
Mailing Address - Fax:314-434-3191
Practice Address - Street 1:226 S WOODS MILL RD
Practice Address - Street 2:37W
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3662
Practice Address - Country:US
Practice Address - Phone:314-523-5300
Practice Address - Fax:314-434-3191
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2016-05-17
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Provider Licenses
StateLicense IDTaxonomies
MO2015011432207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology