Individual
BRUCE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-3849
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
51160
GA
207P00000X
Emergency Medicine Physician
Primary
51160
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10064673
AMERIGROUP
GA
05
—
G51160
—
GA
05
—
G651160
—
SC
01
—
N362163
WELLCARE
GA
Enumeration date
05/18/2006
Last updated
12/26/2007
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