Individual
MARVIN D TARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 TOWER ROAD, SUITE 350, MARIETTA, GA 30060-9415
(770) 590-1078
(770) 422-7306
Mailing address
400 TOWER RD NE, SUITE 350, MARIETTA, GA 30060-9415
(770) 590-1078
(770) 422-7306
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
018257
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000155339E
—
GA
Enumeration date
08/16/2006
Last updated
04/08/2011
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