MEDICARE: DR. MARY F. FARLEY M.D.

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	207N00000X	Dermatology Physician	2002-00683	NC
2	207N00000X	Dermatology Physician	D0065712	MD
3	207ND0101X	MOHS-Micrographic Surgery Physician	D0065712	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447218847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY F. FARLEY M.D.

Provider Business Mailing Address
First Line	:	703 GIDDINGS AVE
Second Line	:	SUITE 700
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-1411
Country	:	US
Telephone Number	:	410-263-5439
Fax Number	:	410-263-7482

Provider Business Practice Location Address
First Line	:	703 GIDDINGS AVE
Second Line	:	SUITE 700
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-1411
Country	:	US
Telephone Number	:	410-263-5439
Fax Number	:	410-263-7482

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	10/05/2020

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