| Marlo Bruno, Llc | |
|
191 Preston Dr Pawleys Island SC 29585-6320 | |
| (610) 405-0436 | |
| Not Available |
| Full Name | Marlo Bruno, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 191 Preston Dr, Pawleys Island, South Carolina |
| Authorized Official Name and Position | Marlo Bruno (OWNER) |
| Authorized Official Contact | 6104050436 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marlo Bruno, Llc Po Box 761 Pawleys Island SC 29585-0761 Ph: () - | Marlo Bruno, Llc 191 Preston Dr Pawleys Island SC 29585-6320 Ph: (610) 405-0436 |
| NPI Number | 1104452770 |
|---|---|
| Provider Enumeration Date | 03/16/2020 |
| Last Update Date | 03/16/2020 |
| Medicare PECOS PAC ID | 9739519307 |
|---|---|
| Medicare Enrollment ID | O20200422001234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104452770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Marlo Denise Bruno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861787152 PECOS PAC ID: 5991921207 Enrollment ID: I20141008000267 |
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