Provider Demographics
NPI:1750358396
Name:LOMONICO, MARION P (MD)
Entity type:Individual
Prefix:DR
First Name:MARION
Middle Name:P
Last Name:LOMONICO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:604 HOAGIE DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-1884
Mailing Address - Country:US
Mailing Address - Phone:410-893-4844
Mailing Address - Fax:410-893-4927
Practice Address - Street 1:604 HOAGIE DR
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1884
Practice Address - Country:US
Practice Address - Phone:410-893-4844
Practice Address - Fax:410-893-4927
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD379082080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM30082OtherCDS
MDBL1758335OtherDEA
MDE16607Medicare UPIN