Basic Information
| Provider Information | |||||||||
| NPI: | 1114940798 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAREY | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 207 GILPIN AVE | ||||||||
| Address2: | |||||||||
| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219214904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103925632 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 W HIGH ST | ||||||||
| Address2: | SUITE 214 | ||||||||
| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219215529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109969490 | ||||||||
| FaxNumber: | 4109969493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D0025915 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | F504002 | 01 | FEDERAL BS PROV ID# | OTHER | 41894003 | 01 | MD | MD BLUE SHIELD PROV ID# | OTHER | 297599 | 01 | MAMSI PROVIDER ID# | OTHER | 275851200 | 05 | MD | MEDICAID |