Individual
DR. MARY L MARCUZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1723 WASHINGTON BLVD, HUNTINGTON, WV 25701-5317
(304) 523-5021
Mailing address
1723 WASHINGTON BLVD, HUNTINGTON, WV 25701-5317
(304) 523-5023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19564
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1803384000
—
WV
05
—
2564407
—
OH
05
—
64102239
—
KY
01
—
P00263543
MEDICARE-RR PROVIDER NUMBER
WV
Enumeration date
01/03/2006
Last updated
04/14/2021
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