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General NPI Number Information
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NPI Number | 1043709256
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Entity Type | Individual
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Provider Name | MARVIN PAUL
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Gender | Male
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 6200 ROCKSIDE WOODS BLVD N
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2333
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Country | US
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Telephone | 216-496-3516
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Fax |
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Provider Business Mailing Address
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Address Line | 2219 E 89TH ST
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City | CLEVELAND
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State | OH
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Zip | 44106-3401
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Country | US
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Telephone | 216-496-3516
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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