Individual
FITZGERALD MARCELIN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
702 N MAIN ST, EMPORIA, VA 23847-1242
(434) 634-7723
(434) 634-7725
Mailing address
PO BOX 70, VICTORIA, VA 23974-0070
(434) 696-2165
(434) 696-1557
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101231381
VA
208000000X
Pediatrics Physician
0101231381
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285818229
—
VA
05
—
5861128
—
VA
05
—
89065FC
—
NC
Enumeration date
12/27/2007
Last updated
02/03/2014
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