Provider Demographics
NPI:1588664593
Name:BARWICK, MICHAEL W (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:BARWICK
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 1:2658 PEERY DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028
Mailing Address - Country:US
Mailing Address - Phone:410-734-7531
Mailing Address - Fax:410-734-7553
Practice Address - Street 1:6701 NORTH CHARLES STREET
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:443-849-3171
Practice Address - Fax:443-849-8826
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD58767207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD75859903OtherBLUE SHIELD
MDP00047388OtherRAILROAD MEDICARE
MDP00126974OtherRAILROAD MED
MD600647 01OtherBLUE SHIELD
MD40042300Medicaid
MDP00126974OtherRAILROAD MED
MD600647 01OtherBLUE SHIELD
MD40042300Medicaid
MDK647F301Medicare PIN