Provider Demographics
NPI:1972602530
Name:PHARR, MARIA ENGSTROM (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ENGSTROM
Last Name:PHARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:905 THUNDER RD STE 140
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-7672
Mailing Address - Country:US
Mailing Address - Phone:252-334-0320
Mailing Address - Fax:855-330-7320
Practice Address - Street 1:905 THUNDER RD STE 140
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-7672
Practice Address - Country:US
Practice Address - Phone:252-334-0320
Practice Address - Fax:855-330-7320
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2001-01591207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG30468Medicare UPIN