| Marvor Healthcare Pllc | |
|
3818 N Elm St Ste E Greensboro NC 27455-2778 | |
| (336) 508-2203 | |
| Not Available |
| Full Name | Marvor Healthcare Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3818 N Elm St Ste E, Greensboro, North Carolina |
| Authorized Official Name and Position | James Johnston (OWNER) |
| Authorized Official Contact | 3365082203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marvor Healthcare Pllc 3818 N Elm St Ste E Greensboro NC 27455-2778 Ph: (336) 508-2203 | Marvor Healthcare Pllc 3818 N Elm St Ste E Greensboro NC 27455-2778 Ph: (336) 508-2203 |
| NPI Number | 1134787385 |
|---|---|
| Provider Enumeration Date | 06/03/2019 |
| Last Update Date | 06/03/2019 |
| Medicare PECOS PAC ID | 5890026892 |
|---|---|
| Medicare Enrollment ID | O20191004002317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134787385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Udo Uchendu Ariwodo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568797736 PECOS PAC ID: 6204024789 Enrollment ID: I20101228000434 |
| Provider Name | Yashica Ruffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073753497 PECOS PAC ID: 3678744588 Enrollment ID: I20110927000086 |
| Provider Name | Owen Trevor Guess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518360544 PECOS PAC ID: 6103173760 Enrollment ID: I20180727001791 |
| Provider Name | Melissa Sheree Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457811994 PECOS PAC ID: 9931430949 Enrollment ID: I20191004002908 |
| Provider Name | Livina Imo Eshiet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841758422 PECOS PAC ID: 0749513117 Enrollment ID: I20200410001473 |
| Provider Name | Mary Tidoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073142881 PECOS PAC ID: 0547683237 Enrollment ID: I20200714002186 |
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