Provider Demographics
NPI:1568858736
Name:PARHAM, MARGARET MAULTSBY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MAULTSBY
Last Name:PARHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:LOUISE
Other - Last Name:MAULTSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PCS BOX 20137
Mailing Address - Street 2:8TH COMM BAS II MEF
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-0137
Mailing Address - Country:US
Mailing Address - Phone:910-450-8772
Mailing Address - Fax:
Practice Address - Street 1:8TH COMM BAS II MEF
Practice Address - Street 2:PCS BOX 20137
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28546-0137
Practice Address - Country:US
Practice Address - Phone:910-450-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-02537208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program