Provider Demographics
NPI:1740396365
Name:MUIR, MARSHA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:LEE
Last Name:MUIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MACIA
Other - Middle Name:LEE
Other - Last Name:MUIRR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MARSHA MUIR
Mailing Address - Street 1:7960 SOQUEL DR
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3995
Mailing Address - Country:US
Mailing Address - Phone:831-429-6755
Mailing Address - Fax:
Practice Address - Street 1:1779 DOMINICAN WAY
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1526
Practice Address - Country:US
Practice Address - Phone:831-479-4966
Practice Address - Fax:831-479-4967
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50446207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92977Medicare UPIN
CAZZZ30740ZMedicare ID - Type UnspecifiedMEDICARE NUMBER