Mary C. Fahrenbach, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD14752 Issued in ME

Practice address

96 Campus Drive
Suite 1
Scarborough, ME 04074

Phone

(207) 885-9905

Fax

(207) 396-5600

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maine Cardiology Associates

  • Cardiovascular Disease Physician
  • South Portland, ME
  • NPI 1205836749
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1003858895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE ONE",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DRIVE",
            "address_2": "SUITE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "207-885-9905",
            "fax_number": "207-396-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRENBACH",
        "first_name": "MARY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "MD14752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "036238",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30200169",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296830099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith L Entwistle, LCSW
• Jeryl Erickson, M.S.
• Sean Michael Etheridge, PA-C
• Brenda Belarger Eugley, PTA
• Jean Fahey, PSY.D.
• Kelly Falone
• Family Hope
• Abtin Farahmand, MD
• Benedict J Farino, MD
• Michael Francis Farino, D.M.D.

• Cardiovascular Disease Physician in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Cardiovascular Disease Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.