Marshall, Lisa Gayle
Marshall, Lisa Gayle is an individual health care provider with primary practice located at 123 Professional Park Dr 101, Mooresville NC 28117. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Marshall, Lisa Gayle can be contacted via phone (704) 662-7081.Contact Information
Primary practice address
123 Professional Park Dr 101
Mooresville NC 28117
Phone: (704) 662-7081
Fax: (704) 663-5693
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 29771 | North Carolina |
Profile Details
| NPI number | 1366516015 |
|---|---|
| LBN Legal business name | Marshall, Lisa Gayle |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 17th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366516015 | NPPES |
| North Carolina | MEDICAID | 8954098 | |
| North Carolina | Other | 29771 |
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