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General NPI Number Information
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NPI Number | 1851008882
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Entity Type | Organization
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Legal Business Name | JONAH MARSHALL MD PLLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 83 BULLOCK RD
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City | SLINGERLANDS
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State | NY
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Zip | 12159
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Country | US
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Telephone | 585-305-6421
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Fax |
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Provider Business Mailing Address
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Address Line | 83 BULLOCK RD
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City | SLINGERLANDS
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State | NY
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Zip | 12159
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Country | US
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Telephone | 585-305-6421
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Fax | 585-305-6421
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONAH MARSHALL
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Credential | MD
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Telephone | 585-305-6421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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