Healthcare Provider Details

I. General information

NPI: 1154594232
Provider Name (Legal Business Name): ANTHONY SCOTT MARSHALL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK
WHEELING WV
26003-6379
US

IV. Provider business mailing address

109 MOUNT WOOD RD STE 1
WHEELING WV
26003-2632
US

V. Phone/Fax

Practice location:
  • Phone: 304-233-2455
  • Fax:
Mailing address:
  • Phone: 304-233-2455
  • Fax: 304-233-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS016071
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2455
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: