Individual
ANDREW VICTOR MARINICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-2663
Mailing address
507 N 17TH STREET, MILWAUKEE, WI 53233
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C09018
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/22/2023
Last updated
08/16/2023
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