Basic Information
| Provider Information | |||||||||
| NPI: | 1700223872 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARCELO | ||||||||
| FirstName: | CAROLYN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 980102 | ||||||||
| Address2: | VCU DIVISION OF GENERAL INTERNAL MEDICINE | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232980102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048283144 | ||||||||
| FaxNumber: | 8048288660 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 E MARSHALL ST | ||||||||
| Address2: | MCV NORTH HOSPITAL | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232985054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048283144 | ||||||||
| FaxNumber: | 8048288660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2013 | ||||||||
| LastUpdateDate: | 06/27/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101260534 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.