Healthcare Provider Details

I. General information

NPI: 1811965536
Provider Name (Legal Business Name): CHRISTOPHER M FARRELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 FRANKLIN AVE STE 201
BERLIN MD
21811-1237
US

IV. Provider business mailing address

2101 MEDICAL PARK DR STE 110
SILVER SPRING MD
20902-4053
US

V. Phone/Fax

Practice location:
  • Phone: 410-629-0366
  • Fax: 410-629-0365
Mailing address:
  • Phone: 301-681-5400
  • Fax: 301-681-5806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0066540
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: