Individual
LESLIE PATRICIA MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-5030
(215) 707-3494
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-5030
(215) 707-3494
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34673
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54101
BLUE CROSS BLUE SHIELD
—
05
—
8954101
—
NC
Enumeration date
01/11/2006
Last updated
03/07/2023
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