Individual
MICHAEL F. MARAVENTANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
175 MADISON AVE, CHOP CARE NETWORK @VIRTUA MEMORIAL HOSPITAL, MOUNT HOLLY, NJ 08060-2038
(609) 914-6226
(609) 261-5842
Mailing address
100 E PENN SQ, 9TH FL, PHILADELPHIA, PA 19107-3323
(267) 425-9258
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA07749200
NJ
208000000X
Pediatrics Physician
MD421934
PA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
25MA07749200
NJ
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
MD421934
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044270
—
NJ
01
—
2416654000
AMERIHEALTH
NJ
Enumeration date
06/06/2006
Last updated
11/03/2014
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