Individual
DR. MICHAEL R MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-1348
(570) 271-6214
(570) 271-5613
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
MD456635
PA
208600000X
Surgery Physician
40501
KY
208600000X
Surgery Physician
MD456635
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200862650
—
IN
01
—
2833136000
PASSPORT ADVANTAGE
KY
01
—
50014427
PASSPORT
KY
05
—
64130560
—
KY
01
—
MA467930
MEDICARE
PA
Enumeration date
07/26/2006
Last updated
08/31/2020
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