Provider Demographics
NPI:1285969840
Name:GAROVOY, MARVIN ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:ROBERT
Last Name:GAROVOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DUTCH VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1015
Mailing Address - Country:US
Mailing Address - Phone:415-454-9052
Mailing Address - Fax:415-453-6152
Practice Address - Street 1:9 DUTCH VALLEY LN
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-1015
Practice Address - Country:US
Practice Address - Phone:415-454-9052
Practice Address - Fax:415-453-6152
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
G28644174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist