Provider Demographics
NPI:1508892589
Name:FERRARESE, JAMES GUIDO (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GUIDO
Last Name:FERRARESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1177 SPARROW MILL WAY
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6136
Mailing Address - Country:US
Mailing Address - Phone:410-420-0426
Mailing Address - Fax:
Practice Address - Street 1:260 GATEWAY DR
Practice Address - Street 2:SUITE #20A
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4268
Practice Address - Country:US
Practice Address - Phone:410-420-7630
Practice Address - Fax:410-420-7911
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0057041207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG63313Medicare UPIN