Provider Demographics
NPI:1164447835
Name:PARKER, MARCHETA VALENTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCHETA
Middle Name:VALENTINE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6275 UNIVERSITY DR NW STE 37368
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-1776
Mailing Address - Country:US
Mailing Address - Phone:256-656-8874
Mailing Address - Fax:
Practice Address - Street 1:3504 OAKWOOD AVE NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-4352
Practice Address - Country:US
Practice Address - Phone:256-656-8864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00023971207L00000X, 208D00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-30884OtherBCBS PHYSICIAN BASED CRNA
AL051510516Medicaid
AL515-10516OtherBCBS HOSPITAL BASED CRNA
AL050089325OtherRAILROAD MEDICARE
AL515-10516OtherBCBS HOSPITAL BASED CRNA