Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036075838 | IL |
N | 111NI0900X | Internist | 036075838 | IL |
Y | 207R00000X | Internist | 2020-04536 | NC |
Y | 111NI0900X | Internist | 2020-04536 | NC |
N | 207RH0002X | Hospice and Palliative Medicine | 2020-04536 | NC |
NPI | 1285734665 |
---|---|
Provider Name | Michael Charles Marschke |
First Address | Flat Rock, NC 28731-9447 |
Second Address | Flat Rock, NC 28731-9447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036075838 | (05) | IL |
E18840 | (02) |