Provider Demographics
NPI:1992776330
Name:MARFO, MAGDALENE (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDALENE
Middle Name:
Last Name:MARFO
Suffix:
Gender:F
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:PO BOX 79029
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28271-7046
Mailing Address - Country:US
Mailing Address - Phone:704-979-8210
Mailing Address - Fax:704-979-8510
Practice Address - Street 1:2315 W ARBORS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2577
Practice Address - Country:US
Practice Address - Phone:704-979-8210
Practice Address - Fax:704-979-8510
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC130YROtherBCBS
NCP00243828OtherRAILROAD MEDICARE
NC89130YRMedicaid
SC7762Medicare PIN
NC130YROtherBCBS
NCP00243828OtherRAILROAD MEDICARE