MEDICARE: MELANIE MARSHALL 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
1	207Q00000X	Family Medicine Physician	27845	OK

General Provider Information

NPI Number	:	1649590837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE MARSHALL MD

Provider Business Mailing Address
First Line	:	5300 N INDEPENDENCE AVE
Second Line	:	SUITE 280
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5556
Country	:	US
Telephone Number	:	405-470-2590
Fax Number	:	405-470-0619

Provider Business Practice Location Address
First Line	:	9417 N COUNCIL RD STE 200
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-6207
Country	:	US
Telephone Number	:	405-470-2590
Fax Number	:	405-470-0619

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

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	03/15/2019

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Directions to “ MELANIE MARSHALL MD” Practice Location

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