DR. MARSHALL LEROY UPSHUR MD NPI 1174681092

NPI Information

  • NPI: 1174681092
  • Provider Name: DR. MARSHALL LEROY UPSHUR, MD
  • Classification: Optometrist - 152WP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 14139 POTOMAC MILLS ROAD
    WOODBRIDGE, VA
    ZIP 22192
  • Phone: (703) 490-8400

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NPI Details

DR. Marshall Leroy Upshur, MD is a pediatrics optometrist in Woodbridge, VA. The provider is optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. DR. Marshall Leroy Upshur, MD NPI is 1174681092. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

14139 POTOMAC MILLS ROAD
WOODBRIDGE, VA
ZIP 22192-644
Phone: (703) 490-8400
Fax: (703) 490-7635

The enumeration date for this NPI number is 12/4/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WP0200XOptometristPediatrics0101037842VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F42337MEDICARE UPIN
2002120K32MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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