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NPI Code Detail

MEDICARE: DAVID BRANDENBURG MARSH NP-C

MEDICARE: DAVID BRANDENBURG MARSH NP-C
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
1363LA2200XAdult Health Nurse PractitionerA005143AR

General Provider Information

NPI Number : 1396272894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BRANDENBURG MARSH NP-C
Provider Business Mailing Address
First Line : 525 W UMPQUA ST
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-2952
Country : US
Telephone Number : 865-719-6702
Fax Number : 541-464-7106
Provider Business Practice Location Address
First Line : 525 W UMPQUA ST
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-2952
Country : US
Telephone Number : 541-464-7141
Fax Number : 541-464-7106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2017
Last Update Date : 11/10/2020

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