Provider Demographics
NPI:1750300174
Name:KIRSHNER, MARC S (DO)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:S
Last Name:KIRSHNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17978
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-7978
Mailing Address - Country:US
Mailing Address - Phone:804-289-4937
Mailing Address - Fax:
Practice Address - Street 1:7640 E PARHAM RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4300
Practice Address - Country:US
Practice Address - Phone:804-591-2200
Practice Address - Fax:804-591-2204
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3363207L00000X
VA0102036962207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005746817Medicaid
VA050046864OtherRAILROAD MEDICARE
VA005746817Medicaid
VA050000583Medicare PIN