MEDICARE: SEJAL MARVANIA

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
1	183500000X	Pharmacist	A1-0004961	DE
2	183500000X	Pharmacist	5302039962	MI

General Provider Information

NPI Number	:	1346799947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEJAL MARVANIA

Provider Business Mailing Address
First Line	:	636 S MARYLAND AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19804-1632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	636 S MARYLAND AVE
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19804-1632
Country	:	US
Telephone Number	:	302-994-3473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2016
Last Update Date	:	09/25/2016

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Directions to “ SEJAL MARVANIA ” Practice Location

Language	Start Address	Practice Location

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