Provider Demographics
NPI:1699952366
Name:MARANDET, NOE JUSTIN (MD)
Entity type:Individual
Prefix:DR
First Name:NOE
Middle Name:JUSTIN
Last Name:MARANDET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3038 W 850 S
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:IN
Mailing Address - Zip Code:46914-9810
Mailing Address - Country:US
Mailing Address - Phone:765-689-8920
Mailing Address - Fax:765-689-7486
Practice Address - Street 1:3038 W 850 S
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:IN
Practice Address - Zip Code:46914-9810
Practice Address - Country:US
Practice Address - Phone:765-689-8920
Practice Address - Fax:765-689-7486
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042010A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery