Provider Demographics
NPI:1689817173
Name:MAROTTA, GIA ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:GIA
Middle Name:ELENA
Last Name:MAROTTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GIA
Other - Middle Name:ELENA
Other - Last Name:HOOSIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1204 N MOUND ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4027
Mailing Address - Country:US
Mailing Address - Phone:936-568-8425
Mailing Address - Fax:
Practice Address - Street 1:1023 N MOUND ST STE A
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4453
Practice Address - Country:US
Practice Address - Phone:936-564-3020
Practice Address - Fax:936-559-8747
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR9099207YX0602X, 207Y00000X
OH35124270207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0107957Medicaid
OH1689817173OtherBWC
OHH358240Medicare PIN