Provider Demographics
NPI:1386639466
Name:TATAR, BARRY STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:STEVEN
Last Name:TATAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8178 LARK BROWN RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6438
Mailing Address - Country:US
Mailing Address - Phone:410-799-3940
Mailing Address - Fax:410-799-3944
Practice Address - Street 1:8178 LARK BROWN RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6438
Practice Address - Country:US
Practice Address - Phone:410-799-3940
Practice Address - Fax:410-799-3944
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033303174400000X, 207Y00000X
MDD33303207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB66959Medicare UPIN
MD146724ZCZSMedicare PIN