Provider Demographics
NPI:1447218847
Name:FARLEY, MARY F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:FARLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:703 GIDDINGS AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1411
Mailing Address - Country:US
Mailing Address - Phone:410-263-5439
Mailing Address - Fax:410-263-7482
Practice Address - Street 1:703 GIDDINGS AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1411
Practice Address - Country:US
Practice Address - Phone:410-263-5439
Practice Address - Fax:410-263-7482
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002-00683207N00000X
MDD0065712207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133M3Medicaid
NCH78257Medicare UPIN
2011295Medicare ID - Type Unspecified