Provider Demographics
NPI:1760645519
Name:ELFREY, MARY KATHERINE (DO)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:ELFREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARY KATE
Other - Middle Name:
Other - Last Name:PLANTHOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3407 WILKENS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5222
Mailing Address - Country:US
Mailing Address - Phone:410-644-5111
Mailing Address - Fax:410-644-2715
Practice Address - Street 1:3407 WILKENS AVE STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5222
Practice Address - Country:US
Practice Address - Phone:410-644-5111
Practice Address - Fax:410-644-2715
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0078507207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease