Provider Demographics
NPI:1295779759
Name:MEISENBERG, BARRY ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ROSS
Last Name:MEISENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:443-481-6483
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:DONNER PAVILION
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-5824
Practice Address - Fax:443-481-5890
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD51260207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
58860014OtherBCBSDC
4555514OtherAETNA PPO
MD722890200Medicaid
54562805OtherBCBSMD
6643364OtherAETNA HMO
54562804OtherBCBS MARYLAND
K6410005OtherBCBS DC
P4560001OtherBCBS DC
MD545620-01OtherBLUE CROSS/BLUE SHIELD
54562804OtherBCBS MD
MD545620-01OtherBLUE CROSS/BLUE SHIELD
MD722890200Medicaid