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General NPI Number Information
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NPI Number | 1073782033
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Entity Type | Organization
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Legal Business Name | MELANIE K. MARSHALL, DDS, MD, PA
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 902 S SALISBURY AVE
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City | SPENCER
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State | NC
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Zip | 28159-2065
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Country | US
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Telephone | 704-636-7215
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Fax | 704-636-2898
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Provider Business Mailing Address
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Address Line | PO BOX 29
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City | SPENCER
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State | NC
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Zip | 28159-0029
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Country | US
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Telephone | 704-636-7215
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Fax | 704-636-2898
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELANIE K. MARSHALL
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Credential | MD, DDS
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Telephone | 704-636-7215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 6840
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License Number State | NC
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