Provider Demographics
NPI:1013146133
Name:FAHRMAN, WHITNEY ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:ANNE
Last Name:FAHRMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MARVEL CT
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4053
Mailing Address - Country:US
Mailing Address - Phone:410-822-9801
Mailing Address - Fax:410-822-9805
Practice Address - Street 1:405 MARVEL CT
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4053
Practice Address - Country:US
Practice Address - Phone:410-822-9801
Practice Address - Fax:410-822-9805
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2140152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD225804800Medicaid
MD225804800Medicaid
MD163493ZERRMedicare PIN
MD163493ZERFMedicare PIN
MD163493ZERMMedicare PIN
MD1204740001Medicare NSC
MD163493ZEYMMedicare PIN