Healthcare Provider Details
I. General information
NPI: 1336061571
Provider Name (Legal Business Name): MARVIN COLBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1505 SPRING PL NW
WASHINGTON DC
20010-1207
US
IV. Provider business mailing address
10908 BUCKNELL DR APT 1331
WHEATON MD
20902-4358
US
V. Phone/Fax
- Phone: 202-569-2365
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: