Provider Demographics
NPI:1790967818
Name:FOLAYAN, MARSHA A (MD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:A
Last Name:FOLAYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:2843 SAINT ROSE PKWY
Practice Address - Street 2:#110
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4813
Practice Address - Country:US
Practice Address - Phone:702-616-7049
Practice Address - Fax:702-492-1467
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV13149207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1790967818Medicaid
NV1790967818Medicaid