Provider Demographics
NPI:1467415729
Name:FARNER, MICHAEL C (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:FARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7710
Mailing Address - Country:US
Mailing Address - Phone:856-770-0504
Mailing Address - Fax:856-751-0535
Practice Address - Street 1:901 ROUTE 168
Practice Address - Street 2:SUITE 301-305
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3210
Practice Address - Country:US
Practice Address - Phone:856-374-4031
Practice Address - Fax:856-751-0535
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA076143002085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
139672OtherUNITED HEALTHCARE
1490034OtherHIGHMARK PA BLUE SHIELD
60023455OtherHORIZON NJ HEALTH
5700490OtherFIRST HEALTH
00332780OtherRAILROAD MEDICARE
1281188OtherAETNA
NJ0007625Medicaid
2179727000OtherAMERIHEALTH
A3738029OtherOXFORD HEALTH
11606671OtherCAQH
NJ072391A2DMedicare PIN
11606671OtherCAQH