Individual
SHAWN D MARVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3344 N FUTRALL DR, FAYETTEVILLE, AR 72703-4057
(479) 443-5316
(479) 582-7389
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E5000
AR
2085R0202X
Diagnostic Radiology Physician
ME106037
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002472600
—
FL
Enumeration date
04/09/2007
Last updated
06/02/2016
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