Provider Demographics
NPI:1689026395
Name:MARSHALL, ELIZABETH M (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1027 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1302
Mailing Address - Country:US
Mailing Address - Phone:989-652-5210
Mailing Address - Fax:989-652-3741
Practice Address - Street 1:1027 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1302
Practice Address - Country:US
Practice Address - Phone:989-652-5210
Practice Address - Fax:989-652-3741
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2021-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301119381207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1912995465Medicaid