Individual
DR. MARSHALL L CHAMBLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1125 N CHURCH ST, GREENSBORO, NC 27401-1007
(336) 832-8035
Mailing address
1125 N CHURCH ST, GREENSBORO, NC 27401-1007
(336) 832-8035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9600329
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14725
PARTNERS MEDICARE
NC
01
—
21961
BCBSNC
NC
01
—
4308504
AETNA
NC
01
—
64949
MEDCOST
NC
05
—
8921961
—
NC
Enumeration date
05/04/2006
Last updated
09/24/2021
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