Provider Demographics
NPI:1215037676
Name:CLASSEN, JOHN BARTHELOW (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BARTHELOW
Last Name:CLASSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3637 ROCKDALE RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-2617
Mailing Address - Country:US
Mailing Address - Phone:410-377-8526
Mailing Address - Fax:
Practice Address - Street 1:3059 SOLOMONS ISLAND RD
Practice Address - Street 2:SUITE F-2
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1433
Practice Address - Country:US
Practice Address - Phone:410-956-3394
Practice Address - Fax:410-956-3324
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052684207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine