Healthcare Provider Details

I. General information

NPI: 1275529679
Provider Name (Legal Business Name): MARVIN BLAINE BYARD R.PH., C.G.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK WHEELING HOSPITAL PHARMACY DEPARTMENT
WHEELING WV
26003-6379
US

IV. Provider business mailing address

1433 SUNSET LN
GLEN DALE WV
26038-1124
US

V. Phone/Fax

Practice location:
  • Phone: 304-243-3278
  • Fax: 304-243-6422
Mailing address:
  • Phone: 304-233-8109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number3492
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number3492
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: