Individual
PAUL J. MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1850 TOWN CENTER PKWY, SUITE 301, RESTON, VA 20190-3219
(703) 709-9701
(703) 709-8084
Mailing address
2012 SWANS NECK WAY, RESTON, VA 20191-4035
(703) 264-2814
(703) 709-8084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0000402
MD
363AS0400X
Surgical Physician Assistant
Primary
0110840218
VA
Other
Enumeration date
11/01/2006
Last updated
08/16/2021
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