Provider Demographics
NPI:1841277027
Name:LYNCH, BARLOW ST CLAIR (MD)
Entity type:Individual
Prefix:
First Name:BARLOW
Middle Name:ST CLAIR
Last Name:LYNCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7321 HANOVER PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3616
Mailing Address - Country:US
Mailing Address - Phone:301-474-1324
Mailing Address - Fax:301-474-1327
Practice Address - Street 1:699 W COCOA BEACH CSWY STE 506
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-3562
Practice Address - Country:US
Practice Address - Phone:321-631-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD30609208800000X
FLME136412208800000X
IL036147923208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOI025OtherMEDICARE HF
DC351561300Medicaid
FL112274100Medicaid