Provider Demographics
NPI:1003890708
Name:MCFARREN, KRISTA LYN (MD)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:LYN
Last Name:MCFARREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NEW MEXICO AVE NW STE 132
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3622
Mailing Address - Country:US
Mailing Address - Phone:202-966-0606
Mailing Address - Fax:
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:SUITE 102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3622
Practice Address - Country:US
Practice Address - Phone:202-966-0606
Practice Address - Fax:202-244-6757
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD328212085R0202X
MDD00408452085R0202X
VAO1012306972085R0202X
WAMD000440332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
470001526OtherRR MEDICARE
300135374OtherRR MEDICARE
MD411090100Medicaid
DC144484YB3HMedicare PIN
DC144484YZBMedicare PIN
DC008983W30Medicare PIN
470001526OtherRR MEDICARE
300135374OtherRR MEDICARE
MD411090100Medicaid
DC00B427O31Medicare PIN
H54706Medicare UPIN
MDFMX003Medicare PIN
MD575P192HMedicare PIN