MEDICARE: MARSHA DAVIS BENSHIR OD

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	152W00000X	Optometrist	DAO821	MD

General Provider Information

NPI Number	:	1649268806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA DAVIS BENSHIR OD

Provider Business Mailing Address
First Line	:	164 W MAIN ST
Second Line	:	STE B
City	:	NEW MARKET
State	:	MD
Zip	:	21774-6279
Country	:	US
Telephone Number	:	301-865-1800
Fax Number	:	301-865-1973

Provider Business Practice Location Address
First Line	:	164 W MAIN ST
Second Line	:	NEW MARKET
City	:	NEW MARKET
State	:	MD
Zip	:	21774-6279
Country	:	US
Telephone Number	:	301-829-1910
Fax Number	:	301-865-1973

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	03/16/2016

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