Healthcare Provider Details

I. General information

NPI: 1881668952
Provider Name (Legal Business Name): MICHAEL SCOTT MARSHALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E BELT LINE RD STE 150
CEDAR HILL TX
75104-2424
US

IV. Provider business mailing address

950 E BELT LINE RD STE 150
CEDAR HILL TX
75104-2424
US

V. Phone/Fax

Practice location:
  • Phone: 972-291-7863
  • Fax: 972-291-0942
Mailing address:
  • Phone: 972-291-7863
  • Fax: 972-291-0942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number42970
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH0602
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: