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NPI Code Detail

MEDICARE: DR. TIMOTHY LEROY MARSHALL MD

MEDICARE: DR. TIMOTHY LEROY MARSHALL MD
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
1207R00000XInternal Medicine Physician0101029169VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122678597OTHERVATRICARE
2007284OTHERVABLUE CROSS/BLUE SHEILD
312873OTHERVAOPTIMA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5266683OTHERVAMDIPA

General Provider Information

NPI Number : 1275645376
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY LEROY MARSHALL MD
Provider Business Mailing Address
First Line : 48 NEWMARKET SQ
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23605-2721
Country : US
Telephone Number : 757-825-8030
Fax Number : 757-847-9149
Provider Business Practice Location Address
First Line : 48 NEWMARKET SQ
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23605-2721
Country : US
Telephone Number : 757-825-8030
Fax Number : 757-847-9149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 02/08/2023

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