Provider Demographics
NPI:1811055353
Name:BARNHART, MARY LOUISA (MD)
Entity type:Individual
Prefix:
First Name:MARY LOUISA
Middle Name:
Last Name:BARNHART
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:PO BOX 6283
Mailing Address - Street 2:
Mailing Address - City:CHINA VILLAGE
Mailing Address - State:ME
Mailing Address - Zip Code:04926-0283
Mailing Address - Country:US
Mailing Address - Phone:207-649-9394
Mailing Address - Fax:
Practice Address - Street 1:10 WATER ST
Practice Address - Street 2:SUITE 306
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6559
Practice Address - Country:US
Practice Address - Phone:207-861-3488
Practice Address - Fax:207-861-3470
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME014402084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME311000099Medicaid
MEMM4165Medicare ID - Type Unspecified