Provider Demographics
NPI:1356300834
Name:SCHUL, MARLIN W (MD)
Entity Type:Individual
Prefix:
First Name:MARLIN
Middle Name:W
Last Name:SCHUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 EDINBURGH WAY
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-6976
Mailing Address - Country:US
Mailing Address - Phone:765-479-4216
Mailing Address - Fax:
Practice Address - Street 1:1836 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4639
Practice Address - Country:US
Practice Address - Phone:850-872-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME137749202K00000X, 2086S0129X, 207P00000X
IN01041607A202K00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLKCIEXOtherBLUE CROSS
IN000000488878OtherANTHEM PROVIDER NUMBER
IN11398636OtherCAQH
IN815150BBBMedicare PIN
F70401Medicare UPIN