Provider Demographics
NPI:1871598995
Name:MAROTTA, RAYMOND PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:PAUL
Last Name:MAROTTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1450 SACHEM PL
Mailing Address - Street 2:UNIT 201
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2554
Mailing Address - Country:US
Mailing Address - Phone:434-973-9744
Mailing Address - Fax:434-973-9790
Practice Address - Street 1:1450 SACHEM PL
Practice Address - Street 2:UNIT 201
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2554
Practice Address - Country:US
Practice Address - Phone:434-973-9744
Practice Address - Fax:434-973-9790
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101033468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA142738OtherSOUTHERN HEALTH/COVENTRY
VA7731310002OtherCIGNA HEALTHCARE
VA012125-5OtherANTHEM BLUE CROSS BLUE SH
VA45140OtherOPTIMA HEALTH
VAB06665Medicare UPIN