Provider Demographics
NPI:1841250081
Name:MARVELLI, CHRISTOPHER A (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:A
Last Name:MARVELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3073 WHITE MOUNTAIN HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-7101
Mailing Address - Country:US
Mailing Address - Phone:603-356-4949
Mailing Address - Fax:603-356-2604
Practice Address - Street 1:3073 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-7101
Practice Address - Country:US
Practice Address - Phone:603-356-4949
Practice Address - Fax:603-356-2604
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210811208600000X
NHT-0700208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000007017OtherBMC
MA808084OtherHARVARD PILGRIM
MA0151122Medicaid
MA04-3194547OtherGREAT-WEST
MA751196OtherCONNECTICARE
H46753Medicare UPIN
MA04-3194547OtherPHCS
MA28808OtherHNE
MAJ23969OtherBCBSMA
MA04-3194547OtherNORTH AMERICAN PREFERRED
MD3587519OtherCIGNA
MA04-3194547OtherPLAN VISTA
MA04-3194547OtherUNICARE/GIC
MA2634585OtherAETNA
A32909Medicare ID - Type Unspecified
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA04-3194547OtherCONSOLIDATED
MA210811OtherTUFTS
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA04-3194547OtherUNITED HEALTHCARE