Active NPI
Marshall Balderston, DO
- Internal Medicine Physician
- Detroit, MI
National Provider Identifier
1205570850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 5101029284
- Practice address
- 6071 W Outer Dr
Detroit, MI 48235-2624 - Phone
- (313) 966-3250
- NPI assigned
- Apr 20, 2022
- Last updated
- Aug 24, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 5101029284 | MI | Primary |
Addresses
Primary practice location
6071 W Outer Dr
Detroit, MI 48235-2624
Mailing address
33437 Hampton Rd
Eugene, OR 97405-9539
Phone (541) 556-5129
Other practice location 1
10000 Telegraph Rd
Taylor, MI 48180-3330
Phone (313) 295-5000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbalderston3652424@epic00.corewelldirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1205570850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33437 HAMPTON RD",
"city": "EUGENE",
"state": "OR",
"postal_code": "974059539",
"telephone_number": "541-556-5129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6071 W OUTER DR",
"city": "DETROIT",
"state": "MI",
"postal_code": "482352624",
"telephone_number": "313-966-3250"
}
],
"practiceLocations": [
{
"address_1": "10000 Telegraph Rd",
"address_purpose": "LOCATION",
"city": "Taylor",
"state": "MI",
"postal_code": "481803330",
"country_code": "US",
"telephone_number": "313-295-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALDERSTON",
"first_name": "MARSHALL",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-20",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5101029284",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbalderston3652424@epic00.corewelldirect.org",
"affiliation": "N",
"address_1": "10000 Telegraph Rd",
"city": "Taylor",
"state": "MI",
"country_code": "US",
"postal_code": "481803330",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.