National Provider Identifier Database

MARLON PEMBERTON
Medical Technologist


Contact Information

MARLON PEMBERTON
1604 VISA DR STE 1
NORMAL, IL61761-2195
Phone: 309-454-1100
Fax: 309-454-1107
Website:
Specialty Taxonomy Code
* Medical Technologist 246QM0706X

* Indicates primary specialty

NPI Profile & details for MARLON PEMBERTON

NPI Number 1942746185
Credentials
Entity Individual
Enumeration date 01/11/2017
Last updated 01/11/2017 - About 9 years ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 246ZE0600X
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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