Provider Demographics
NPI:1821164831
Name:SPEAR, MARVIN NELSON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:NELSON
Last Name:SPEAR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 SOUNDSIDE ROAD
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-8919
Mailing Address - Country:US
Mailing Address - Phone:252-482-4846
Mailing Address - Fax:
Practice Address - Street 1:323 S BROAD ST
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1933
Practice Address - Country:US
Practice Address - Phone:252-482-2127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15572183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist