Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 39646 | NC |
N | 207V00000X | Obstetrician & Gynecologist | 39646 | NC |
NPI | 1023100526 |
---|---|
Provider Name | Dr. John Everett Marshall |
First Address | Lincolnton, NC 28092-4402 |
Second Address | Lincolnton, NC 28092-4402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
54088 | BLUE CROSS/BLUE SHIELD (01) | NC |
8954088 | (05) | NC |
D69581 | (02) | NC |