Individual
DR. MARVEN H WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1985 SPRINGFIELD AVE, MAPLEWOOD, NJ 07040-3435
(973) 763-5010
(973) 761-6980
Mailing address
1985 SPRINGFIELD AVE, MAPLEWOOD, NJ 07040-3435
(973) 763-5010
(973) 761-6980
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA01881900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588401
—
NJ
Enumeration date
01/17/2007
Last updated
07/08/2007
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