Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 7124 | SC |
NPI | 1023352200 |
---|---|
Provider Name | William Alexander Marshall |
First Address | Spartanburg, SC 29302-1605 |
Second Address | Spartanburg, SC 29302-1605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2012 |
Last Update Date | 12/11/2012 |