Provider Demographics
NPI:1275869752
Name:BARR, MAURA MACDONALD (DO)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:MACDONALD
Last Name:BARR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-0350
Mailing Address - Country:US
Mailing Address - Phone:215-723-2333
Mailing Address - Fax:215-257-1800
Practice Address - Street 1:325 CENTRAL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3265
Practice Address - Country:US
Practice Address - Phone:610-644-6755
Practice Address - Fax:610-647-2063
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015024207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10247114630002Medicaid