Individual
MR. MARK DUANE MARSHALL
Active
Individual
MR. MARK DUANE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8937
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-17254
MEDICA ONAMIA
MN
01
—
122391
UCARE
MN
01
—
520T2MA
BLUE CROSS CLINIC
MN
01
—
520T3MA
BLUE CROSS HOSPITAL
MN
05
—
745392200
—
MN
01
—
HP44081
HEALTH PARTNERS
MN
01
—
NA9091011247
PREFERRED ONE
MN
Enumeration date
05/18/2006
Last updated
02/25/2010
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