Boyd, Marvin Tillman

Boyd, Marvin Tillman is an sole proprietor health care provider with primary practice located at 350 Boulvard The Boyd Renal Clinic St. Mary'S Hospital Ambulatory Services,, Passaic NJ 07055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Boyd, Marvin Tillman can be contacted via phone (973) 594-7800.

Contact Information

Primary practice address
350 Boulvard The Boyd Renal Clinic St. Mary'S Hospital Ambulatory Services, Passaic NJ 07055
Phone: (973) 594-7800
Fax: (973) 594-7801
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 25MA03839300 New Jersey

Profile Details

NPI number 1417095126
LBN Legal business name Boyd, Marvin Tillman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2007
Last updated Oct 2nd, 2012 - about 13 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 1417095126 NPPES
New Jersey MEDICAID 0371106

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