Organization
CEDAR RIDGE CRITICAL CARE MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN P MARON MD (PRESIDENT)
(925) 482-8233
Entity
Organization
Contact information
Practice address
651 DUNLOP LN, CLARKSVILLE, TN 37040-5015
(931) 502-1000
(386) 274-7801
Mailing address
PO BOX 11531, DAYTONA BEACH, FL 32120-1531
(386) 274-7800
(386) 274-7801
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/04/2018
Last updated
12/12/2018
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