Individual
DR. MARVIN CARSON ALVISO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301092447
MI
207Q00000X
Family Medicine Physician
Primary
M-11390
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932365533
—
ID
Enumeration date
08/03/2008
Last updated
02/04/2014
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