Tark, Marvin D
Tark, Marvin D is an sole proprietor health care provider with primary practice located at 400 Tower Road Suite 350, Marietta GA 30060-9415. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Tark, Marvin D can be contacted via phone (770) 590-1078.Contact Information
Primary practice address
400 Tower Road Suite 350
Marietta GA 30060-9415
Phone: (770) 590-1078
Fax: (770) 422-7306
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 018257 | Georgia |
Profile Details
| NPI number | 1548373210 |
|---|---|
| LBN Legal business name | Tark, Marvin D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 16th, 2006 |
| Last updated | Apr 8th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548373210 | NPPES |
| Georgia | MEDICAID | 000155339E |
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