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Organization
S S MARATHE MD PA
Active
Organization
S S MARATHE MD PA
Active
Other names
Medical Specialists PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHRIRAM S MARATHE MD (PRESIDENT)
(904) 824-8158
Entity
Organization
Contact information
Practice address
665 STATE ROAD 207, SUITE 102, ST AUGUSTINE, FL 32084-5938
(904) 824-8158
(904) 823-1284
Mailing address
665 STATE ROAD 207, SUITE 102, ST AUGUSTINE, FL 32084-5938
(904) 824-8158
(904) 823-1284
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250270400
—
FL
Enumeration date
05/12/2006
Last updated
06/19/2008
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