Individual
MARK D MARILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 SE HOSPITAL AVE, STUART, FL 34994-2346
(772) 287-5200
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
200700105
NC
207RG0100X
Gastroenterology Physician
21216
ND
207RG0100X
Gastroenterology Physician
21764
WV
207RG0100X
Gastroenterology Physician
350085209
GA
207RG0100X
Gastroenterology Physician
DR.0067585
CO
207RG0100X
Gastroenterology Physician
MD192722
OR
207RG0100X
Gastroenterology Physician
MD425171
PA
207RG0100X
Gastroenterology Physician
Primary
ME157995
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011688500001
—
PA
05
—
115206300
—
FL
01
—
144T9
BCBSNC
NC
05
—
2521248
—
OH
05
—
3810001403
—
WV
05
—
5906555
—
NC
01
—
SZ970
MEDICARE HF
FL
Enumeration date
06/24/2005
Last updated
06/17/2025
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