Provider Demographics
NPI:1104070820
Name:MARINO, BAPTISTE S (MD)
Entity type:Individual
Prefix:DR
First Name:BAPTISTE
Middle Name:S
Last Name:MARINO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1707
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28106-1707
Mailing Address - Country:US
Mailing Address - Phone:336-240-3500
Mailing Address - Fax:877-546-5252
Practice Address - Street 1:1212 MANN DRIVE
Practice Address - Street 2:MEIDCAL SUITE 200
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105
Practice Address - Country:US
Practice Address - Phone:704-841-0992
Practice Address - Fax:877-546-5252
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34079208100000X, 2081S0010X, 2083X0100X, 208D00000X, 204C00000X, 207L00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8950665Medicaid