Provider Demographics
NPI:1386612844
Name:FIELDS, JO ANN (MD)
Entity type:Individual
Prefix:DR
First Name:JO ANN
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 SHAREN DR STE E
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-7956
Mailing Address - Country:US
Mailing Address - Phone:302-242-8918
Mailing Address - Fax:410-543-8213
Practice Address - Street 1:2604 OLD OCEAN CITY RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4629
Practice Address - Country:US
Practice Address - Phone:302-242-8918
Practice Address - Fax:410-543-8213
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2017-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10004729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000729701Medicaid
DEG00373Medicare PIN
DE0000729701Medicaid