Basic Information
| Provider Information | |||||||||
| NPI: | 1073608709 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RICHARD P MARVEL, MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 LUBRANO DR | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214017038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105731436 | ||||||||
| FaxNumber: | 4105731442 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 LUBRANO DR | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214017038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105731436 | ||||||||
| FaxNumber: | 4105731442 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 06/05/2011 | ||||||||
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| AuthorizedOfficialLastName: | MARVEL | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | PAUL | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4105731436 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | D51388 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
No ID Information.