Petronilo Marcelo Jr.

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

2ND Medical Battalion PSC Box 20129
Camp Lejeune, NC 28454-0129

Phone

(910) 451-6943

NPI assigned

Jan 2, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1023354586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 WOODRUFF CT",
            "city": "HUBERT",
            "state": "NC",
            "postal_code": "28539",
            "telephone_number": "619-341-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2ND MEDICAL BATTALION PSC BOX 20129",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "284540129",
            "telephone_number": "910-451-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELO",
        "first_name": "PETRONILO",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-02",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher G Maliken, DMD
• Jolene Angela Mancini, AU.D.
• Kimberly Mandel
• Ryan Joseph Mango
• Matthew Manley, DDS
• Samuel David Markham
• Geramy M. Marks
• Deidra Rae Marques, BSN, RN
• Luis E Marquez, M.D.
• Gregory Marr, LAT, ATC

• Independent Duty Corpsman in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.