Provider Demographics
NPI:1275781338
Name:FEHR, MARK LOREN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:LOREN
Last Name:FEHR
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ST. PAUL PLACE
Mailing Address - Street 2:TOWER, 5TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202
Mailing Address - Country:US
Mailing Address - Phone:410-659-2802
Mailing Address - Fax:
Practice Address - Street 1:301 ST. PAUL PLACE
Practice Address - Street 2:POB # 804
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202
Practice Address - Country:US
Practice Address - Phone:410-649-3485
Practice Address - Fax:410-659-2817
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361280032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology