Provider Demographics
NPI:1497860290
Name:MAGNUS, BARRY M (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:M
Last Name:MAGNUS
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 1:8522 WINDOW LATCH WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5633
Mailing Address - Country:US
Mailing Address - Phone:410-487-8600
Mailing Address - Fax:
Practice Address - Street 1:609 GLOBAL WAY
Practice Address - Street 2:CONCENTRA
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-0001
Practice Address - Country:US
Practice Address - Phone:410-487-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA711442083X0100X
MDD0071608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine