Individual
PETER R MARCELLUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 STATE HIGHWAY 248, STE, 202, BRANSON, MO 65616-3758
(417) 335-7000
Mailing address
1150 STATE HIGHWAY 248, STE, 202, BRANSON, MO 65616-3758
(417) 335-7000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3E69
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080110697
RAILROAD MEDICARE
—
01
—
1107752
HEALTHLINK
—
01
—
1667
COX HEALTH SYSTEMS
—
05
—
202071965
—
MO
01
—
8068
BCBS
—
01
—
P00237019
RAILROAD MEDICARE
—
Enumeration date
06/19/2006
Last updated
09/12/2012
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