Individual provider Active NPI

Stefano Pablo Marcuard, MD

  • Gastroenterology Physician
  • Greenville, NC
National Provider Identifier
1548245202
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
27614 Issued in NC
Practice address
428 Forrest Park
Greenville, NC 27858-6612
Phone
(252) 341-3730
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 27614 NC Primary

Addresses

Primary practice location

428 Forrest Park
Greenville, NC 27858-6612

Mailing address

428 Forrest Park
Greenville, NC 27858-6612
Phone (252) 341-3730

Other practice location 1

704 WH Smith Blvd
Greenville, NC 27834
Phone (252) 758-8181

Other identifiers 1

IdentifierTypeStateIssuer
895390MMedicaidNC

Other names 1

  • Dr. Stefan P Marcuard Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1548245202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 FORREST PARK",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278586612",
            "telephone_number": "252-341-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 FORREST PARK",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278586612",
            "telephone_number": "252-341-3730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 WH Smith Blvd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "27834",
            "country_code": "US",
            "telephone_number": "252-758-8181",
            "fax_number": "252-758-8182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCUARD",
        "first_name": "STEFANO",
        "middle_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "27614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "895390M",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFAN",
            "last_name": "MARCUARD",
            "middle_name": "P",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.