Provider Demographics
NPI:1326001173
Name:FAY, BETSY A (MD)
Entity Type:Individual
Prefix:DR
First Name:BETSY
Middle Name:A
Last Name:FAY
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 1:3730 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1813
Mailing Address - Country:US
Mailing Address - Phone:410-235-0999
Mailing Address - Fax:877-423-2298
Practice Address - Street 1:3730 FALLS RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-1813
Practice Address - Country:US
Practice Address - Phone:410-235-0999
Practice Address - Fax:877-423-2298
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D69441Medicare UPIN