Individual
KEVIN YORK MARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 BILLINGSLEY RD, CHARLOTTE, NC 28211-1009
(704) 358-2700
(704) 358-2716
Mailing address
PO BOX 60724, CHARLOTTE, NC 28260-0724
(704) 358-2700
(704) 358-2716
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2010-01478
NC
390200000X
Student in an Organized Health Care Education/Training Program
149310
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497916795
—
NC
05
—
NC1897
—
SC
Enumeration date
06/19/2008
Last updated
11/29/2016
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