Provider Demographics
NPI:1164902730
Name:MARVAR, MARY BARBARA II
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BARBARA
Last Name:MARVAR
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6518 DETROIT AVE APT 319
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3058
Mailing Address - Country:US
Mailing Address - Phone:216-225-1839
Mailing Address - Fax:
Practice Address - Street 1:6518 DETROIT AVE APT 319
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-3058
Practice Address - Country:US
Practice Address - Phone:216-225-1839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health