Provider Demographics
NPI:1518961150
Name:BARR, MICHAEL STUART (MD, MBA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STUART
Last Name:BARR
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SILVER CLIPPER LN
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3480
Mailing Address - Country:US
Mailing Address - Phone:443-865-4662
Mailing Address - Fax:
Practice Address - Street 1:201 JORDAN RD STE 200
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-4495
Practice Address - Country:US
Practice Address - Phone:828-820-7276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054277207R00000X
DCMD035761207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD240767ZADTMedicare PIN
MDS732678XMedicare ID - Type Unspecified
MDF63556Medicare UPIN