Provider Demographics
NPI:1194305672
Name:MAROUN, CHARBEL (MD)
Entity type:Individual
Prefix:
First Name:CHARBEL
Middle Name:
Last Name:MAROUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHARBEL
Other - Middle Name:GEORGES
Other - Last Name:MAROUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2706 SOUTHWIND DRIVE
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450
Mailing Address - Country:US
Mailing Address - Phone:617-763-2733
Mailing Address - Fax:
Practice Address - Street 1:400 LINWOOD DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450
Practice Address - Country:US
Practice Address - Phone:870-205-2125
Practice Address - Fax:870-205-2126
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312735207X00000X
MA288206207X00000X
ARE-15760207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery