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NPI Code Detail

MEDICARE: MICHAEL MARSHALL

MEDICARE: MICHAEL MARSHALL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMA001071LPA

General Provider Information

NPI Number : 1003810961
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MARSHALL
Provider Business Mailing Address
First Line : 1005 CAMPUS CIR
Second Line :
City : HERMITAGE
State : PA
Zip : 16148-7901
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1005 CAMPUS CIR
Second Line :
City : HERMITAGE
State : PA
Zip : 16148-7901
Country : US
Telephone Number : 724-346-2677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 03/25/2021

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Directions to “ MICHAEL MARSHALL ” Practice Location

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