# ATLANTIC UROLOGY CLINICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447293790
- **Authorized official:** SHADEN MARZOUK MD (US PRESIDENT)
- **Authorized official phone:** (239) 931-7254

## Contact information

- **Practice address:** 3600 SEA MOUNTAIN HWY STE B, LITTLE RIVER, SC 29566-8161
- **Practice address phone:** (843) 399-9696
- **Practice address fax:** (843) 399-9596
- **Mailing address:** 1419 SE 8TH TER STE 200, CAPE CORAL, FL 33990-3213
- **Mailing address phone:** (239) 931-7342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 09/25/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4522 | — | SC |