Provider Demographics
NPI:1003951773
Name:MARQUINA, P SHERRON
Entity type:Individual
Prefix:DR
First Name:P SHERRON
Middle Name:
Last Name:MARQUINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10115 MERRIMAC RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1877
Mailing Address - Country:US
Mailing Address - Phone:804-320-3514
Mailing Address - Fax:
Practice Address - Street 1:9210 FOREST HILL AVE
Practice Address - Street 2:SUITE B-3
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-6880
Practice Address - Country:US
Practice Address - Phone:804-377-2222
Practice Address - Fax:804-377-2223
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555972111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U73220Medicare UPIN