MEDICARE: DR. KARSON NICOLE MARVEL AU.D.

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	231H00000X	Audiologist	01555	MD

General Provider Information

NPI Number	:	1962079780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARSON NICOLE MARVEL AU.D.

Provider Business Mailing Address
First Line	:	1215 BRANDY SPRINGS RD
Second Line	:
City	:	PARKTON
State	:	MD
Zip	:	21120-9748
Country	:	US
Telephone Number	:	443-695-2397
Fax Number	:

Provider Business Practice Location Address
First Line	:	1447 YORK RD STE 312
Second Line	:
City	:	LUTHERVILLE TIMONIUM
State	:	MD
Zip	:	21093-6052
Country	:	US
Telephone Number	:	410-583-7021
Fax Number	:

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

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	02/02/2022

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