MEDICARE: MRS. MARIA ENGSTROM PHARR MD

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	207Q00000X	Family Medicine Physician	2001-01591	NC

General Provider Information

NPI Number	:	1972602530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA ENGSTROM PHARR MD

Provider Business Mailing Address
First Line	:	905 THUNDER RD STE 140
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-7672
Country	:	US
Telephone Number	:	252-334-0320
Fax Number	:	855-330-7320

Provider Business Practice Location Address
First Line	:	905 THUNDER RD STE 140
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-7672
Country	:	US
Telephone Number	:	252-334-0320
Fax Number	:	855-330-7320

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	03/14/2024

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