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NPI Code Detail

MEDICARE: MARVIN VAN ROANE

MEDICARE: MARVIN VAN ROANE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerVA

General Provider Information

NPI Number : 1063345502
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARVIN VAN ROANE
Provider Business Mailing Address
First Line : 2025 E MAIN ST STE 110
Second Line :
City : RICHMOND
State : VA
Zip : 23223-7072
Country : US
Telephone Number : 804-805-5146
Fax Number : 866-239-7181
Provider Business Practice Location Address
First Line : 105 W BANK ST
Second Line :
City : PETERSBURG
State : VA
Zip : 23803-3215
Country : US
Telephone Number : 804-805-5146
Fax Number : 866-239-7181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ MARVIN VAN ROANE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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