Individual
DR. GEORGE KENNETH MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
13305A MIDLOTHIAN TPKE, MIDLOTHIAN, VA 23113-4211
(804) 378-1818
(804) 794-3827
Mailing address
239 WYLDEROSE CT, MIDLOTHIAN, VA 23113-6848
(804) 378-1818
(804) 794-3827
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000786
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480011660
RAILROAD MEDICARE PIN
VA
05
—
9332014
—
VA
Enumeration date
07/26/2005
Last updated
07/27/2017
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