Active NPI
Andrea L Marvin, M.D.
- Pediatrics Physician
- Wilmington, DE
National Provider Identifier
1376557330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C1-0007766
- Practice address
- 4512 Kirkwood Hwy
Suite 101
Wilmington, DE 19808-5123 - Phone
- (302) 633-6338
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C1-0007766 | DE | Primary |
Addresses
Primary practice location
4512 Kirkwood Hwy
Suite 101
Wilmington, DE 19808-5123
Mailing address
9 Halsey Dr
Wilmington, DE 19807-2239
Phone (302) 661-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000039099 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1-0007766 | DE | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376557330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 HALSEY DR",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198072239",
"telephone_number": "302-661-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4512 KIRKWOOD HWY",
"address_2": "SUITE 101",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198085123",
"telephone_number": "302-633-6338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARVIN",
"first_name": "ANDREA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C1-0007766",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000039099",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.