Provider Demographics
NPI:1609964493
Name:SHERNOCK-SIRDOFSKY, MARSHA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:
Last Name:SHERNOCK-SIRDOFSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8348 TRAFORD LN
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1663
Mailing Address - Country:US
Mailing Address - Phone:703-451-5200
Mailing Address - Fax:703-451-0044
Practice Address - Street 1:8348 TRAFORD LN
Practice Address - Street 2:SUITE 301
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1663
Practice Address - Country:US
Practice Address - Phone:703-451-5200
Practice Address - Fax:703-451-0044
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101 031409208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine