Individual
MARISA DEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
332 N TRADE ST, SUITE 2000, MATTHEWS, NC 28105-1728
(704) 302-8500
Mailing address
332 N TRADE ST, MATTHEWS, NC 28105-1728
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2005-00652
NC
207R00000X
Internal Medicine Physician
51776
SC
Other
Enumeration date
07/12/2006
Last updated
02/12/2019
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