Provider Demographics
NPI:1467597765
Name:BARNES MARSHALL, MICHELLE D (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:D
Last Name:BARNES MARSHALL
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 1:2440 M ST, NW
Mailing Address - Street 2:STE 317
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1404
Mailing Address - Country:US
Mailing Address - Phone:202-775-5990
Mailing Address - Fax:202-775-5993
Practice Address - Street 1:2440 M ST, NW
Practice Address - Street 2:STE 317
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:202-775-5990
Practice Address - Fax:202-775-5993
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCS9308133208000000X
DCMD20145208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC027079400Medicaid
G20262Medicare UPIN