Individual
JOHN W MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 RIDGE ST, SUITE 202, COUNCIL BLUFFS, IA 51503-4643
(712) 325-0022
(712) 325-8102
Mailing address
201 RIDGE ST, SUITE 202, COUNCIL BLUFFS, IA 51503-4643
(712) 325-0022
(712) 325-8102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20313
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166561
—
IA
01
—
0400056
UNITED HEALTH CARE
—
01
—
16656
WELLMARK
IA
01
—
20278
COVENTRY
—
Enumeration date
11/16/2006
Last updated
07/08/2007
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