Provider Demographics
NPI:1710070206
Name:MARSHALL, KATHY L (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:L
Last Name:MARSHALL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3100 SPRING FOREST ROAD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0705
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:5801 BREMO ROAD
Practice Address - Street 2:AMERICAN ANESTHESIOLOGY OF VIRGINIA, PC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1907
Practice Address - Country:US
Practice Address - Phone:804-828-9160
Practice Address - Fax:804-828-8300
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-02-10
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Provider Licenses
StateLicense IDTaxonomies
VA0101054258207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005706611Medicaid
VA005706611Medicaid
VAG35908Medicare UPIN