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NPI Code Detail

MEDICARE: DR. MARSHALL L CHAMBLISS MD

MEDICARE: DR. MARSHALL L CHAMBLISS 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
1207Q00000XFamily Medicine Physician9600329NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
414725OTHERNCPARTNERS MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14308504OTHERNCAETNA
221961OTHERNCBCBSNC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
564949OTHERNCMEDCOST

General Provider Information

NPI Number : 1629026471
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARSHALL L CHAMBLISS MD
Provider Business Mailing Address
First Line : 1125 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1007
Country : US
Telephone Number : 336-832-8035
Fax Number :
Provider Business Practice Location Address
First Line : 1125 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1007
Country : US
Telephone Number : 336-832-8035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 09/24/2021

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Directions to “ DR. MARSHALL L CHAMBLISS MD” Practice Location

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