Individual
AMANDA MAE MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5110 E SOUTHERN AVE, MESA, AZ 85206-2791
(480) 295-8072
Mailing address
5110 E SOUTHERN AVE, MESA, AZ 85206-2791
(480) 295-8072
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37073
SC
207Q00000X
Family Medicine Physician
Primary
54116
AZ
Other
Enumeration date
06/23/2014
Last updated
09/19/2019
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