Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD447961 | PA |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | C55834 | CA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD447961 | PA |
NPI | 1487622239 |
---|---|
Provider Name | Spyridon I Marinis |
First Address | Butler, PA 16001-4651 |
Second Address | Butler, PA 16001-4651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 08/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1007317143084 | (05) | PA |
1487622239 | (05) | CA |
293407NHM | MEDICARE (01) | PA |
MD447961 | MEDICAL LICENSE (01) | PA |