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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
4869 PALM COAST PKWY NW, SUITE 2, PALM COAST, FL 32137-3661
(386) 445-2003
Mailing address
665 STATE ROAD 207, SUITE 102, ST AUGUSTINE, FL 32084-5938
(904) 824-8158

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
250270401
FL
Enumeration date
08/06/2007
Last updated
06/19/2008
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