Provider Demographics
NPI:1639592983
Name:MARRO, MICHAEL ANGELO (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:MARRO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:165 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-9811
Mailing Address - Country:US
Mailing Address - Phone:802-748-9405
Mailing Address - Fax:802-748-4540
Practice Address - Street 1:201 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:VT
Practice Address - Zip Code:05824-0355
Practice Address - Country:US
Practice Address - Phone:802-695-2512
Practice Address - Fax:802-695-1303
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2024-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT0320134219207Q00000X
NY273509-1207Q00000X
NJ25MB10027900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine