Individual
MS. CARMELLA CHARMAYNE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
611 DENBIGH BLVD, NEWPORT NEWS, VA 23608-4415
(757) 283-8300
(910) 323-3951
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003117
VA
363AM0700X
Medical Physician Assistant
0010-05753
NC
363AM0700X
Medical Physician Assistant
C0004211
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730417262
—
NC
Enumeration date
11/20/2009
Last updated
10/27/2021
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