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General NPI Number Information
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NPI Number | 1447775606
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Entity Type | Individual
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Provider Name | MS. MARQUIS SHANTEL HAM
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Gender | Female
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Dates
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Enumeration Date | 08/09/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6421 STRAIGHTSTONE RD
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City | LONG ISLAND
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State | VA
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Zip | 24569-2839
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Country | US
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Telephone | 434-713-1738
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Fax | 434-299-3002
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Provider Business Mailing Address
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Address Line | 6421 STRAIGHTSTONE RD
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City | LONG ISLAND
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State | VA
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Zip | 24569-2839
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Country | US
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Telephone | 434-713-1738
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Fax | 434-299-3002
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | VA
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