Provider Demographics
NPI:1841366291
Name:SIMPSON, MARSHALL CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:CRAIG
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:MARSHALL
Other - Middle Name:C
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:324A BEACON DR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-7956
Mailing Address - Country:US
Mailing Address - Phone:252-551-5595
Mailing Address - Fax:252-321-7762
Practice Address - Street 1:324A BEACON DR
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-7956
Practice Address - Country:US
Practice Address - Phone:252-551-5595
Practice Address - Fax:252-321-7762
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBS1678664OtherDEA
NC2150309GMedicare PIN
NCBS1678664OtherDEA