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Organization

ATLANTIC UROLOGY CLINICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHADEN MARZOUK MD (US PRESIDENT)
(239) 931-7254
Entity
Organization

Contact information

Practice address
3600 SEA MOUNTAIN HWY STE B, LITTLE RIVER, SC 29566-8161
(843) 399-9696
(843) 399-9596
Mailing address
1419 SE 8TH TER STE 200, CAPE CORAL, FL 33990-3213
(239) 931-7342

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP4522
SC
Enumeration date
06/14/2006
Last updated
09/25/2023
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