Provider Demographics
NPI:1609817253
Name:SCHORIN, MARSHALL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:A
Last Name:SCHORIN
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 1:3020 HAMAKER CT
Mailing Address - Street 2:SUITE #202
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2238
Mailing Address - Country:US
Mailing Address - Phone:571-226-5600
Mailing Address - Fax:571-423-5064
Practice Address - Street 1:3020 HAMAKER CT
Practice Address - Street 2:SUITE #202
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2238
Practice Address - Country:US
Practice Address - Phone:571-226-5600
Practice Address - Fax:571-423-5064
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.06094R2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1329177Medicaid
LA1329177Medicaid
5M104Medicare ID - Type Unspecified