Provider Demographics
NPI:1588798466
Name:MICHAEL R BARNETT M.D, P.A
Entity Type:Organization
Organization Name:MICHAEL R BARNETT M.D, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:EMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-848-6294
Mailing Address - Street 1:295 STONER AVE
Mailing Address - Street 2:STE 106
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5698
Mailing Address - Country:US
Mailing Address - Phone:410-848-6294
Mailing Address - Fax:410-848-3009
Practice Address - Street 1:295 STONER AVE
Practice Address - Street 2:STE 106
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5698
Practice Address - Country:US
Practice Address - Phone:410-848-6294
Practice Address - Fax:410-848-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0034916174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD529181000Medicaid
MD647LMedicare ID - Type Unspecified
MD529181000Medicaid