Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223X0400X | Orthodontists | 019019686 | IL |
Y | 1223X0400X | Orthodontists | 40200 | IA |
NPI | 1063737237 |
---|---|
Provider Name | Dr. Steven D Marshall |
First Address | Iowa City, IA 52242-1001 |
Second Address | Iowa City, IA 52242-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2010 |
Last Update Date | 07/12/2021 |