Provider Demographics
NPI:1396752101
Name:SINGER, MARC BENJAMIN (DPM, PA)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:BENJAMIN
Last Name:SINGER
Suffix:
Gender:M
Credentials:DPM, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 OLD COURT RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2800
Mailing Address - Country:US
Mailing Address - Phone:410-653-3330
Mailing Address - Fax:410-653-3386
Practice Address - Street 1:4000 OLD COURT RD
Practice Address - Street 2:SUITE 105
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-2800
Practice Address - Country:US
Practice Address - Phone:410-653-3330
Practice Address - Fax:410-653-3386
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0674213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD473438600Medicaid
MDT-59876Medicare UPIN
MDT-232Medicare ID - Type Unspecified