Individual
MARIAN M MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1075 N CURTIS RD, STE 200, BOISE, ID 83706-1350
(208) 367-8333
(208) 367-2003
Mailing address
3340 EAST GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10511
MN
363A00000X
Physician Assistant
Primary
PA-853
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
09/29/2008
Last updated
07/14/2010
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