Individual
DR. ANDREW J MARSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6130 S 108TH STREET, HALES CORNERS, WI 53130-2525
(414) 425-8400
(414) 425-8425
Mailing address
6130 S 108TH STREET, HALES CORNERS, WI 53130-2525
(414) 425-8400
(414) 425-8425
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
896-025
WI
213ES0131X
Foot Surgery Podiatrist
Primary
896-025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43239300
—
WI
01
—
P00717384
RAIL ROAD MEDICARE GROUP MEMBER PTAN #
WI
Enumeration date
01/06/2006
Last updated
04/25/2019
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