Provider Demographics
NPI:1538271275
Name:HYETT, MARVIN R (MD)
Entity type:Individual
Prefix:
First Name:MARVIN
Middle Name:R
Last Name:HYETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 NEW ROAD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221
Mailing Address - Country:US
Mailing Address - Phone:609-653-1444
Mailing Address - Fax:609-926-2308
Practice Address - Street 1:2021 NEW ROAD
Practice Address - Street 2:SUITE 10
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221
Practice Address - Country:US
Practice Address - Phone:609-653-1444
Practice Address - Fax:609-926-2308
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA2212800207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B32665Medicare UPIN
NJ428801Medicare ID - Type Unspecified