Boren, Marvin R.

Boren, Marvin R. is an individual health care provider with primary practice located at 4642 Hills Dales Rd Nw , Canton OH 44708-1510. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Boren, Marvin R. can be contacted via phone (330) 477-4400.

Contact Information

Primary practice address
4642 Hills Dales Rd Nw Canton OH 44708-1510
Phone: (330) 477-4400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 36001949 Ohio

Profile Details

NPI number 1356322283
LBN Legal business name Boren, Marvin R.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Jan 9th, 2008 - about 16 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 1356322283 NPPES
Ohio MEDICAID 0433169

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