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Individual

DR. MARSHALL EDWARD MCCABE IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
406 BLACK HILLS LN SW STE A, OLYMPIA, WA 98502
(360) 754-1735
Mailing address
406 BLACK HILLS LN SW STE A, OLYMPIA, WA 98502-8144
(360) 754-1735

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02004673A
IN
207RG0100X
Gastroenterology Physician
Primary
OP60945227
WA
390200000X
Student in an Organized Health Care Education/Training Program
11016698A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201121960
IN
Enumeration date
06/26/2012
Last updated
09/03/2019
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