MEDICARE: DR. MARSHA LEE MUIR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	G50446	CA

General Provider Information

NPI Number	:	1740396365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARSHA LEE MUIR M.D.

Provider Business Mailing Address
First Line	:	7960 SOQUEL DR
Second Line	:
City	:	APTOS
State	:	CA
Zip	:	95003-3995
Country	:	US
Telephone Number	:	831-429-6755
Fax Number	:

Provider Business Practice Location Address
First Line	:	1779 DOMINICAN WAY
Second Line	:	SUITE B
City	:	SANTA CRUZ
State	:	CA
Zip	:	95065-1526
Country	:	US
Telephone Number	:	831-479-4966
Fax Number	:	831-479-4967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/09/2007

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