Individual
DANTE ANTHONY MARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 WHARTON CIR STE 130, TRIADELPHIA, WV 26059-1293
(304) 242-8042
(304) 242-8962
Mailing address
300 WHARTON CIRCLE, STE 130, TRIADELPHIA, WV 26059-1293
(304) 242-8042
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19164
WV
207X00000X
Orthopaedic Surgery Physician
MD441233
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
19164
WV
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098600000
—
WV
05
—
2015269
—
OH
Enumeration date
11/13/2006
Last updated
04/22/2025
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