Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0420012378 | VT |
Y | 207V00000X | Obstetrician & Gynecologist | 47965 | KY |
NPI | 1013175603 |
---|---|
Provider Name | Dr. Kevin Anthony Marques |
First Address | Philadelphia, PA 19178-0982 |
Second Address | Louisville, KY 40202-1831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 22/04/2020 |