MEDICARE: DR. RANETTE Y MARSHALL DO

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
1	207V00000X	Obstetrics & Gynecology Physician	34-00-7633	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	KR10	OTHER	MD	MEDICARE GROUP PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B776	OTHER	DC	BCBS NCA GROUP #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	KR10ME	OTHER	MD	BCBS MD GROUP#
4	1851473722	OTHER	MD	GROUP NPI# - MEDICAL AND SURGICAL CLINICS OF SOUTHERN MARYLAND
6	1366644197	OTHER	MD	GROUP NPI# - WALDORF OB/GYN

General Provider Information

NPI Number	:	1326014549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANETTE Y MARSHALL DO

Provider Business Mailing Address
First Line	:	5100 AUTH WAY
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-4207
Country	:	US
Telephone Number	:	301-702-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 AUTH WAY
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-4207
Country	:	US
Telephone Number	:	301-702-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	07/02/2021

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Directions to “ DR. RANETTE Y MARSHALL DO” Practice Location

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