DR. MARIO MARUTHUR (NPI# 1356738199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356738199 |
Entity Type | Individual |
Full Name | DR. MARIO MARUTHUR |
Credential | M.D. |
Practice Address |
1120 15th St Augusta GA 30912-1059 |
Mailing Address |
1120 15th St Ste Bi1056 Augusta GA 30912-0004 |
Practice Telephone | 7067218623 |
Practice Fax Number | 7067211459 |
Mailing Telephone | 7067213813 |
Enumeration Date | 2015-04-20 |
Last Update Date | 2019-05-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | 82188 | GA | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
1364 Clifton Rd Ne, Atlanta, GA 303221059 | 5016207689 |
Street Address |
1120 15TH ST |
City | AUGUSTA |
State | GA |
Zip Code | 30912-1059 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427051556 | Gyanendra Kumar Sharma | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2005-05-23 |
1912508532 | Lacey Nichol Preston | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-11-02 |
1992302988 | Victoria Mae Pregibon | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-03 |
1275130239 | Tanya Renee Hall | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-02 |
1144847864 | Cassandra Marie Voong | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-29 |
1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
1639795990 | Lauren Christine Bush | Audiologist | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-23 |
1811513575 | Ashley Danielle Fox | Internal Medicine | 1120 15th St, Augusta, GA 30912-0006 | 2020-06-18 |
1265058994 | Matthew Craddock | Psychiatry & Neurology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-18 |
1437775301 | Joseph John Arellano | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
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Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134568520 | Matthew Dean Belcher | Dermatology | 1120 15th St Fl 5, Augusta, GA 30912 | 2013-06-18 |
1073822607 | Edward Hardin Smith Jr. | Dermatology | 514 Winchester Dr, Augusta, GA 30909-3236 | 2010-09-30 |
1093972325 | Jeremiah Allan Miller IIi | Dermatology | 3624 J. Dewey Gray Circle, Suite 250, Augusta West Dermatology, Augusta, GA 30909 | 2008-05-22 |
1225235393 | Sarah Josephson Cely | Dermatology | 820 Saint Sebastian Way Ste 6c, Augusta, GA 30901-2640 | 2007-07-02 |
1649349978 | Augusta Dermatology Associates PC | Dermatology | 820 St Sebastian Way Ste 6c, Augusta, GA 30901 | 2006-11-08 |
1215923073 | Barry L Thompson | Dermatology | 2060 Central Ave, Augusta, GA 30904-4177 | 2005-09-26 |
1437142072 | Fred Jason Kight | Dermatology | 1248 Augusta West Pkwy, Augusta, GA 30909-1854 | 2005-08-30 |
1720516560 | James Petit | Dermatology | 1004 Chafee Ave, Augusta, GA 30904 | 2017-05-24 |
1801272968 | Augusta West Dermatology, LLC | Dermatology | 3624 J Dewey Gray Cir, Suite 250, Augusta, GA 30909-6584 | 2015-07-30 |
1427431048 | Rachel Marks Greenwood | Dermatology | 950 15th St, Augusta, GA 30901-2608 | 2015-07-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.