Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 7361 | SC |
NPI | 1003873654 |
---|---|
Provider Name | Dr. Joseph M Marzluff |
First Address | N Charleston, SC 29406-7140 |
Second Address | N Charleston, SC 29406-7140 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
073618 | (05) | SC |
570832069 | TAX ID (01) | SC |
B92126 | (02) | |
B92126 | (02) | SC |