Provider Demographics
NPI:1275274946
Name:MARCELL, SHAWN JACOB
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:JACOB
Last Name:MARCELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 FORSHEY ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6063
Mailing Address - Country:US
Mailing Address - Phone:985-518-7381
Mailing Address - Fax:
Practice Address - Street 1:1620 FORSHEY ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6063
Practice Address - Country:US
Practice Address - Phone:985-518-7381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program