MEDICARE: MS. AMY M FERANEC PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	C0003164	MD

General Provider Information

NPI Number	:	1215918537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMY M FERANEC PA

Provider Business Mailing Address
First Line	:	200 HOSPITAL DR
Second Line	:	2ND FLOOR CHESAPEAKE ORTHOPAEDICS AND SPORTS MEDICINE
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-5884
Country	:	US
Telephone Number	:	410-768-5555
Fax Number	:	410-768-5835

Provider Business Practice Location Address
First Line	:	200 HOSPITAL DR
Second Line	:	2ND FLOOR CHESAPEAKE ORTHOPAEDICS AND SPORTS MEDICINE
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-5884
Country	:	US
Telephone Number	:	410-768-5555
Fax Number	:	410-768-5835

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	06/08/2020

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