Provider Demographics
NPI:1821524372
Name:MARSHALL, STEVEN (R PH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 COUNTY ROAD 9
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-9590
Mailing Address - Country:US
Mailing Address - Phone:937-593-4702
Mailing Address - Fax:
Practice Address - Street 1:2129 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1557
Practice Address - Country:US
Practice Address - Phone:937-592-3464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03213843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist