Provider Demographics
NPI:1336871904
Name:MARCELLUS, CHRIS EDENS (PA)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:EDENS
Last Name:MARCELLUS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 22403
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4476
Mailing Address - Country:US
Mailing Address - Phone:888-402-7256
Mailing Address - Fax:888-902-1099
Practice Address - Street 1:1417 MONROE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3634
Practice Address - Country:US
Practice Address - Phone:901-296-9400
Practice Address - Fax:901-272-0820
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2025-01-27
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Provider Licenses
StateLicense IDTaxonomies
TN5687363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant