Provider Demographics
NPI:1144276999
Name:MARSCHALK, FREDERICK F (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:F
Last Name:MARSCHALK
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 1:3630 J DEWEY GRAY CIR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1867
Mailing Address - Country:US
Mailing Address - Phone:706-396-2003
Mailing Address - Fax:706-396-2030
Practice Address - Street 1:1500 JOHNS RD
Practice Address - Street 2:STE 5
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4888
Practice Address - Country:US
Practice Address - Phone:706-733-9489
Practice Address - Fax:706-733-7958
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010610207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC902955Medicaid
SC902955Medicaid
GA11BDQRVMedicare ID - Type UnspecifiedMEDICARE PROVIDER #
SC902955Medicaid