Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 032438 | GA |
NPI | 1023172665 |
---|---|
Provider Name | Marshall L. Nash |
First Address | Decatur, GA 30033-6149 |
Second Address | Decatur, GA 30033-6149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00458367H | (05) | GA |
E81361 | (02) | GA |