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General NPI Number Information
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NPI Number | 1174656193
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Entity Type | Individual
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Provider Name | RICHARD CHARLES MARSELLA M.D.,PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5450 KNOLL NORTH DR
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City | COLUMBIA
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State | MD
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Zip | 21045-2300
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Country | US
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Telephone | 443-618-6596
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Fax |
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Provider Business Mailing Address
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Address Line | 8222 MONCTON RD
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City | MILLERSVILLE
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State | MD
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Zip | 21108-1122
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Country | US
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Telephone | 410-987-1208
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | D0024047
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License Number State | MD
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