Provider Demographics
NPI:1326046202
Name:PIEPRZAK, MARY A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:PIEPRZAK
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 1:1589 SULPHUR SPRING RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2542
Mailing Address - Country:US
Mailing Address - Phone:410-536-5400
Mailing Address - Fax:410-737-2168
Practice Address - Street 1:5999 HARPERS FARM RD
Practice Address - Street 2:SUITE W 250
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3013
Practice Address - Country:US
Practice Address - Phone:410-772-8822
Practice Address - Fax:410-772-9274
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD50616207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD390004824OtherMEDICARE B RAILROAD
MD159020100Medicaid
MD390004824OtherMEDICARE B RAILROAD
MD658RMedicare PIN