Provider Demographics
NPI:1205907151
Name:SAVOY, MARINA V (NP)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:V
Last Name:SAVOY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 DENISON ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7002
Mailing Address - Country:US
Mailing Address - Phone:240-731-6985
Mailing Address - Fax:
Practice Address - Street 1:19851 OBSERVATION DR STE 245
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4151
Practice Address - Country:US
Practice Address - Phone:301-315-9515
Practice Address - Fax:866-884-2590
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR134295363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR134295OtherLICENSE
MDG02264C02Medicare ID - Type Unspecified
MDQ16894Medicare UPIN