# DR. MARSHALL L CHAMBLISS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629026471
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 9600329 | NC | Yes |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 09/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 14725 | PARTNERS MEDICARE | NC |
| 01 | — | 21961 | BCBSNC | NC |
| 01 | — | 4308504 | AETNA | NC |
| 01 | — | 64949 | MEDCOST | NC |
| 05 | — | 8921961 | — | NC |