Provider Demographics
NPI:1689389918
Name:BARTH, ELIZABETH (MAC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BARTH
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5634 46TH PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1953
Mailing Address - Country:US
Mailing Address - Phone:202-549-7244
Mailing Address - Fax:
Practice Address - Street 1:5132 BALTIMORE AVE STE 200
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781-2041
Practice Address - Country:US
Practice Address - Phone:240-204-2976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02881171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty