Provider Demographics
NPI:1295776508
Name:PARRIS, MARCIA (MD)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:
Last Name:PARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12150 ANNAPOLIS ROAD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769
Mailing Address - Country:US
Mailing Address - Phone:301-754-2222
Mailing Address - Fax:301-754-2011
Practice Address - Street 1:12150 ANNAPOLIS RD STE 309
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9183
Practice Address - Country:US
Practice Address - Phone:301-754-2222
Practice Address - Fax:301-754-2011
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218453207Q00000X
MDD82329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH54167Medicare UPIN
NY40V451Medicare ID - Type Unspecified