Individual
KATHERINE FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3000 MAPLEWOOD AVE, SUITE 112, WINSTON SALEM, NC 27103-4002
(336) 768-2980
(336) 765-6599
Mailing address
100 S BOYLAN AVE, RALEIGH, NC 27603-1802
(919) 833-7534
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2009-00506
NC
207Q00000X
Family Medicine Physician
217062
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2017661
—
MA
Enumeration date
01/30/2006
Last updated
09/05/2013
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