MEDICARE: MR. STEVEN MARSHALL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1164765368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN MARSHALL

Provider Business Mailing Address
First Line	:	9803 WELCH DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2814
Country	:	US
Telephone Number	:	405-255-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	9803 WELCH DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2814
Country	:	US
Telephone Number	:	405-255-0649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2013
Last Update Date	:	07/25/2023

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Directions to “ MR. STEVEN MARSHALL ” Practice Location

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