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Individual
BRUCE ALLEN MARSHALL
Active
Individual
BRUCE ALLEN MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036102654
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011112
HEALTH ALLIANCE
IL
01
—
020102500
BLACK LUNG
IL
05
—
036102654
—
IL
01
—
08415043
IL BLUE CROSS BLUE SHIELD
IL
01
—
133101600
ACS
IL
01
—
14D0435736
CLIA
IL
01
—
220028805
RR MEDICARE
IL
01
—
32017
PERSONAL CARE ID
IL
01
—
684895
HEALTHLINK
IL
01
—
C12333
RR MEDICARE GROUP
IL
Enumeration date
08/16/2006
Last updated
04/04/2023
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