Provider Demographics
NPI:1285735944
Name:HIRSH, MARC J (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:J
Last Name:HIRSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14610 S MILITARY TRL STE G3
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-3801
Mailing Address - Country:US
Mailing Address - Phone:561-819-3100
Mailing Address - Fax:561-819-3119
Practice Address - Street 1:14610 S MILITARY TRL STE G3
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3801
Practice Address - Country:US
Practice Address - Phone:561-819-3100
Practice Address - Fax:561-819-3119
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76989208VP0014X
FLME 76989207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH18172Medicare UPIN
FL49475WMedicare PIN
FL49475XMedicare ID - Type Unspecified