Provider Demographics
NPI:1801983382
Name:ELLER, BARBARA ANN (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:ELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10632 LITTLE PATUXENT PKWY
Mailing Address - Street 2:STE 406
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3273
Mailing Address - Country:US
Mailing Address - Phone:410-740-8066
Mailing Address - Fax:410-740-8068
Practice Address - Street 1:10632 LITTLE PATUXENT PKWY
Practice Address - Street 2:STE 406
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3273
Practice Address - Country:US
Practice Address - Phone:410-740-8066
Practice Address - Fax:410-740-8068
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00582622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD902122Medicare UPIN