Individual
STEPHANIE D MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
8684 CONNECTICUT ST STE A, MERRILLVILLE, IN 46410-5581
(192) 472-8990
(219) 472-0270
Mailing address
8684 CONNECTICUT ST STE A, MERRILLVILLE, IN 46410-5581
(192) 472-8990
(219) 472-0270
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
02001947A
IN
207RI0011X
Interventional Cardiology Physician
02001947A
IN
207RI0011X
Interventional Cardiology Physician
036-099475
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375757
ANTHEM PIN
IN
05
—
200270150
—
IN
Enumeration date
12/06/2005
Last updated
02/27/2024
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