Provider Demographics
NPI:1194200154
Name:DIFRONZO, MARC (PA-C)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:DIFRONZO
Suffix:
Gender:
Credentials:PA-C
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Mailing Address - Street 1:650 ENTERPRISE BLVD APT 7107
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8550
Mailing Address - Country:US
Mailing Address - Phone:843-412-3661
Mailing Address - Fax:843-412-3661
Practice Address - Street 1:1470 TOBIAS GADSON BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4835
Practice Address - Country:US
Practice Address - Phone:843-825-9905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2025-04-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant