Provider Demographics
NPI:1841468733
Name:HAVEN J. BARLOW, JR., MD, PC
Entity type:Organization
Organization Name:HAVEN J. BARLOW, JR., MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAVEN
Authorized Official - Middle Name:JESSE
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:703-560-8844
Mailing Address - Street 1:8501 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4617
Mailing Address - Country:US
Mailing Address - Phone:703-560-8844
Mailing Address - Fax:703-560-7270
Practice Address - Street 1:8501 ARLINGTON BLVD
Practice Address - Street 2:SUITE 420
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4625
Practice Address - Country:US
Practice Address - Phone:703-560-8844
Practice Address - Fax:703-560-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046280208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE73449Medicare UPIN
VA654519Medicare PIN