Healthcare Provider Details

I. General information

NPI: 1649666025
Provider Name (Legal Business Name): MICHELLE BARNES MARSHALL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2015
Last Update Date: 04/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 M ST NW STE 317
WASHINGTON DC
20037-1404
US

IV. Provider business mailing address

2440 M ST NW STE 317
WASHINGTON DC
20037-1404
US

V. Phone/Fax

Practice location:
  • Phone: 202-775-5990
  • Fax: 202-775-5993
Mailing address:
  • Phone: 202-775-5990
  • Fax: 202-775-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD20145
License Number StateDC

VIII. Authorized Official

Name: MICHELLE DENISE BARNES MARSHALL
Title or Position: OWNER
Credential: M.D.
Phone: 202-775-5990