Provider Demographics
NPI:1720233406
Name:BARRETT TOMAN, RACHELLE ELAINE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:ELAINE
Last Name:BARRETT TOMAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:ELAINE
Other - Last Name:TOMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:4151 BLADENSBURG RD
Mailing Address - Street 2:
Mailing Address - City:COLMAR MANOR
Mailing Address - State:MD
Mailing Address - Zip Code:20722-1928
Mailing Address - Country:US
Mailing Address - Phone:301-699-7700
Mailing Address - Fax:301-779-9001
Practice Address - Street 1:4151 BLADENSBURG RD
Practice Address - Street 2:
Practice Address - City:COLMAR MANOR
Practice Address - State:MD
Practice Address - Zip Code:20722
Practice Address - Country:US
Practice Address - Phone:301-699-7700
Practice Address - Fax:301-779-9001
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-23
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD037903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD028833100Medicaid
DC058280600Medicaid