Alviso, Marvin Carson

Alviso, Marvin Carson is an individual health care provider with primary practice located at 777 N Raymond St , Boise ID 83704-9251. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Alviso, Marvin Carson can be contacted via phone (208) 514-2500.

Contact Information

Primary practice address
777 N Raymond St Boise ID 83704-9251
Phone: (208) 514-2500
Fax: (208) 375-2217
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301092447 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M-11390 Idaho

Profile Details

NPI number 1932365533
LBN Legal business name Alviso, Marvin Carson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2008
Last updated Feb 4th, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932365533 NPPES
Idaho MEDICAID 1932365533

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