Mazzella, Marco S

Mazzella, Marco S is an individual health care provider with primary practice located at 7201 E 147Th St , Grandview MO 64030-4204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Mazzella, Marco S can be contacted via phone (816) 416-4900.

Contact Information

Primary practice address
7201 E 147Th St Grandview MO 64030-4204
Phone: (816) 416-4900
Fax: (816) 416-4901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 0428890 Kansas
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 2004017280 Missouri

Profile Details

NPI number 1033162219
LBN Legal business name Mazzella, Marco S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Jan 4th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033162219 NPPES
Missouri MEDICAID 1033162219
Missouri Other 7563574
Missouri Other A030
Missouri Other P00853573
Missouri Other 34436012
Missouri Other 7563574
Missouri Other P000149535
Missouri Other 431092652
Missouri Other 7563574
Missouri Other P01128616

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