Provider Demographics
NPI:1184735763
Name:FARRIOR, CARMEN LOLITA (MD)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:LOLITA
Last Name:FARRIOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 REISTERSTOWN ROAD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1343
Mailing Address - Country:US
Mailing Address - Phone:410-415-5883
Mailing Address - Fax:
Practice Address - Street 1:1777 REISTERSTOWN ROAD
Practice Address - Street 2:SUITE 235
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1343
Practice Address - Country:US
Practice Address - Phone:410-415-5883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD55960207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD96801300Medicaid
MDH34459Medicare UPIN
MD96801300Medicaid