Provider Demographics
NPI:1033187000
Name:BARRERA, ROBUSTIANO JOCSON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBUSTIANO
Middle Name:JOCSON
Last Name:BARRERA
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 GLENN STREET
Mailing Address - Street 2:SUITE #302
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:240-522-0470
Mailing Address - Fax:240-522-0471
Practice Address - Street 1:200 GLENN STREET
Practice Address - Street 2:SUITE #302
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502
Practice Address - Country:US
Practice Address - Phone:240-522-0470
Practice Address - Fax:240-522-0471
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2012-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0014865207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD002011700Medicaid
WV0083017000Medicaid
WV0083017000Medicaid
MD002011700Medicaid
MDD76124Medicare UPIN