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General NPI Number Information
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NPI Number | 1912193210
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Entity Type | Organization
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Legal Business Name | STEPHEN N MARSHALL DPM PC
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 5700 W GENESEE ST SUITE 221
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City | CAMILLUS
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State | NY
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Zip | 13031
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Country | US
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Telephone | 315-631-3668
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Fax | 315-631-3670
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Provider Business Mailing Address
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Address Line | 5700 W GENESEE ST SUITE 221
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City | CAMILLUS
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State | NY
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Zip | 13031
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Country | US
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Telephone | 315-631-3668
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Fax | 315-631-3670
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN N MARSHALL
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Credential | DPM
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Telephone | 315-631-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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