Individual
MARC CIESCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 15TH STREET BI 5070, AUGUSTA, GA 30912-0004
(706) 721-2423
Mailing address
1120 15TH STREET BI 5070, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52014
SC
Other
Enumeration date
04/29/2015
Last updated
06/06/2019
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