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Individual

DR. GIORGIO M ARU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2500 N STATE ST, R00M L210, JACKSON, MS 39216-4500
(601) 984-5170
(601) 984-5198
Mailing address
PO BOX 24146, JACKSON, MS 39225-4146
(601) 925-6805
(601) 926-4978

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
6210
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0119452
MS
01
14835
MED LICENSE
MS
01
64-0914115
TAX ID#UNIV SURG ASSOC
MS
01
P00634048
RR MEDICARE
MS
Enumeration date
10/05/2006
Last updated
06/27/2012
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