Provider Demographics
NPI:1649268806
Name:BENSHIR, MARSHA DAVIS (OD)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:DAVIS
Last Name:BENSHIR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 W MAIN ST
Mailing Address - Street 2:STE B
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6279
Mailing Address - Country:US
Mailing Address - Phone:301-865-1800
Mailing Address - Fax:301-865-1973
Practice Address - Street 1:164 W MAIN ST
Practice Address - Street 2:NEW MARKET
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6279
Practice Address - Country:US
Practice Address - Phone:301-829-1910
Practice Address - Fax:301-865-1973
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDAO821152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD371LMedicare PIN
MDT31042Medicare UPIN