Provider Demographics
NPI:1477545507
Name:MATARESE, MARGARET BARNES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:BARNES
Last Name:MATARESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:LUCILLE
Other - Last Name:BARNES-RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2403 PIMPERNEL DR
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4944
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11TH MEDICAL GROUP
Practice Address - Street 2:
Practice Address - City:BOLLING AFB
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-404-1466
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65554207Q00000X, 2083A0100X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine