Individual
DEREK LOGAN MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
102 W GRUENTHER RD, GRETNA, NE 68028-4828
(402) 332-2772
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33091
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2018
Last updated
07/12/2021
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