# DR. MARK TERRENCE FAY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1972563781
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | G58765 | CA | — |
| 207W00000X | Ophthalmology Physician | MD16253 | OR | Yes |

## Other

- **Enumeration date:** 03/24/2006
- **Last updated:** 02/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004571003 | BCBS | OR |
| 05 | — | 042937 | — | OR |
| 01 | — | 180011820 | RAILROAD MEDICARE | OR |
| 01 | — | A002 | TRICARE | OR |
| 01 | — | F2640501647611 | VISION SERVICE PLAN | OR |
| 01 | — | XPY094350 | MEDI-CAL | CA |