Individual
DR. DAVID R. MARINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0027
(570) 821-2340
(570) 826-7904
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-3034
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD033476E
PA
2086S0129X
Vascular Surgery Physician
Primary
MD033476E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001005075
—
PA
Enumeration date
03/31/2006
Last updated
07/31/2020
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