Individual
MARSHALL A STATON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 N OAK ST, SUITE 206 MYRTLE OFFICES, MYRTLE BEACH, SC 29577-3579
(843) 448-2824
Mailing address
PO BOX 1066, MYRTLE BEACH, SC 29578-1066
(843) 448-2824
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7368
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA315-7
—
SC
Enumeration date
05/12/2006
Last updated
07/08/2007
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