Provider Demographics
NPI:1336176445
Name:MARSHALL, DONALD CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CRAIG
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 830605
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48 CEDARS RD
Practice Address - Street 2:
Practice Address - City:MUNFORD
Practice Address - State:AL
Practice Address - Zip Code:36268-7191
Practice Address - Country:US
Practice Address - Phone:256-358-4553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL149813Medicaid
AL148552Medicaid
AL511-35694OtherBLUE CROSS
AL149813Medicaid