Bruce a Marshall MD PA
Organization Active NPI Specialist · Clinton, SC
NPI 1356520746 · NPPES record last updated Nov 29, 2011
Key facts
- NPI
- 1356520746
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 9545 (SC)
- Legal business name
- BRUCE A MARSHALL MD PA
- Practice address
- 104 Medical Park CT
Clinton, SC 29325-7537 - Phone
- (864) 833-1978
- Fax
- (864) 833-7688
- NPI assigned
- Nov 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Bruce A Marshall, M.D.
- Title
- Owner
- Phone
- (864) 833-1978
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 9545 | SC | Yes |
Addresses
Primary practice location
104 Medical Park CT
Clinton, SC 29325-7537
Mailing address
PO Box 663
Clinton, SC 29325-0663
Phone (864) 833-1978
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 095453 | Medicaid | SC |
Other providers in Clinton, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.