Healthcare Provider Details

I. General information

NPI: 1255274494
Provider Name (Legal Business Name): ROBERT MARSHALL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4973 GLENWAY AVE
CINCINNATI OH
45238-3907
US

IV. Provider business mailing address

1635 ATSON LN
CINCINNATI OH
45205-1373
US

V. Phone/Fax

Practice location:
  • Phone: 513-386-9362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: