MEDICARE: ANTHONY MATTHEW MARLON MD

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	207RC0000X	Cardiovascular Disease Physician	2625	NV

General Provider Information

NPI Number	:	1700851946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY MATTHEW MARLON MD

Provider Business Mailing Address
First Line	:	1645 VILLAGE CENTER CIR STE 141
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6371
Country	:	US
Telephone Number	:	702-834-7333
Fax Number	:	702-834-7337

Provider Business Practice Location Address
First Line	:	1645 VILLAGE CENTER CIR STE 141
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6371
Country	:	US
Telephone Number	:	702-834-7333
Fax Number	:	702-834-7337

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	10/17/2011

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