Individual
DR. BLAKE ADAM MARVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
NAVAL HEALTH CLINIC CHARLESTON, 110 NNPTC CIRCLE, GOOSE CREEK, SC 29445
(843) 794-6000
Mailing address
2005 KNIGHT LANE, BUILDING H, ATTN: MEDICAL STAFF SERVI, NAVY MEDICINE SUPPORT COMMAND, JACKSONVILLE, FL 32212
(760) 725-8882
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P1103
TX
Other
Enumeration date
06/22/2010
Last updated
09/09/2024
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