Individual
DR. MARJORIE A THURLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1673 MASON AVE, SUITE# 305, DAYTONA BEACH, FL 32117-5515
(386) 274-7118
(386) 274-6173
Mailing address
1673 MASON AVE, SUITE# 305, DAYTONA BEACH, FL 32117-5515
(386) 274-7118
(386) 274-6173
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
ME96441
FL
2085N0700X
Neuroradiology Physician
ME96441
FL
2085N0904X
Nuclear Radiology Physician
ME96441
FL
2085P0229X
Pediatric Radiology Physician
ME96441
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME96441
FL
2085R0203X
Therapeutic Radiology Physician
ME96441
FL
2085U0001X
Diagnostic Ultrasound Physician
ME96441
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09486
BLUE CROSS BLUE SHIELD
FL
05
—
279520500
—
FL
Enumeration date
07/19/2007
Last updated
05/08/2008
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