Healthcare Provider Details

I. General information

NPI: 1184718280
Provider Name (Legal Business Name): MARSHALL EDWARD NOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6167 N FRESNO ST STE 102
FRESNO CA
93710-8610
US

IV. Provider business mailing address

6167 N FRESNO ST STE 102
FRESNO CA
93710-8610
US

V. Phone/Fax

Practice location:
  • Phone: 559-322-2255
  • Fax: 559-322-4636
Mailing address:
  • Phone: 559-322-2255
  • Fax: 559-322-4636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberC400030
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: