Individual
JENNIFER L MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-2564
(920) 320-2201
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
(920) 320-4155
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
56500
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01330869
—
CO
01
—
10019287
LOVELACE HP
NM
01
—
20200396
PRESBYTERIAN HP
NM
05
—
41729595
—
NM
05
—
941410
—
AZ
01
—
NM009T97
BCBS
NM
05
—
T0396
—
UT
Enumeration date
02/08/2006
Last updated
11/18/2011
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