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NPI Code Detail

MEDICARE: DR. LUISA PORTAL MARSTELLER MD

MEDICARE:  DR. LUISA PORTAL MARSTELLER  MD
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
12085R0202XDiagnostic Radiology Physician0101041131VA

General Provider Information

NPI Number : 1437224623
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUISA PORTAL MARSTELLER MD
Provider Business Mailing Address
First Line : 124 THOMAS CARTWRIGHT
Second Line :
City : WILLIAMSBURG
State : VA
Zip : 23185-8904
Country : US
Telephone Number : 757-345-5652
Fax Number :
Provider Business Practice Location Address
First Line : 2221 EDWARD HOLLAND DR
Second Line :
City : RICHMOND
State : VA
Zip : 23230-2518
Country : US
Telephone Number : 804-354-2696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LUISA PORTAL MARSTELLER MD” Practice Location

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