Individual
MS. ANDREA L MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12502 WILLOWBROOK RD, CUMBERLAND, MD 21502-6491
(240) 964-8760
(240) 964-8769
Mailing address
PO BOX 1671, CUMBERLAND, MD 21501-1671
(240) 964-8515
(240) 964-8336
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2017-0020
NM
363AM0700X
Medical Physician Assistant
6675
AZ
363AM0700X
Medical Physician Assistant
Primary
C0002456
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6675
AZ STATE LICENSE
AZ
01
—
C0002456
STATE LICENSE
MD
01
—
PA2017-0020
NM STATE LICENSE
NM
Enumeration date
07/15/2006
Last updated
01/25/2024
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