Provider Demographics
NPI:1760461677
Name:FARMER, MARYANN (DPM)
Entity type:Individual
Prefix:DR
First Name:MARYANN
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 RUGH STREET
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-837-2657
Mailing Address - Fax:724-837-5929
Practice Address - Street 1:545 RUGH ST.
Practice Address - Street 2:SUITE 3000
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-837-2657
Practice Address - Fax:724-837-5929
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002434L213EP1101X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA75973OtherMED PLUS
PA08776936Medicaid
PA5311285OtherAETNA NON-HMO
PA001347416OtherKEYSTONE BLUES HMO - WEST
PA942727OtherAETNA HMO
PAFA084057OtherHIGHMARK BLUE SHIELD
PA942727OtherAETNA HMO
PA08776936Medicaid