Healthcare Provider Details

I. General information

NPI: 1841136983
Provider Name (Legal Business Name): MARLEY MCDONALD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 10TH AVE
COLUMBUS OH
43210-1240
US

IV. Provider business mailing address

5597 SELLS MILL DR
DUBLIN OH
43017-3417
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8566
  • Fax:
Mailing address:
  • Phone: 614-560-7439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberLE-00061351
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: