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General NPI Number Information
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NPI Number | 1114981982
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Entity Type | Individual
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Provider Name | MARSHA LYNNE CUSHMAN DO
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Gender | Female
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 01/23/2008
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Provider Practice Location Address
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Address Line | 950 W WOOSTER ST
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2603
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Country | US
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Telephone | 419-354-9810
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Fax | 419-861-8982
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Provider Business Mailing Address
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Address Line | 934 CLUB LN
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City | SUMTER
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State | SC
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Zip | 29154-6106
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Country | US
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Telephone | 803-934-8044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.006687
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License Number State | OH
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