Provider Demographics
NPI:1932256831
Name:GAUSE, BARRY L (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:GAUSE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11722 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-3302
Mailing Address - Country:US
Mailing Address - Phone:410-833-5000
Mailing Address - Fax:410-833-1433
Practice Address - Street 1:7010 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2902
Practice Address - Country:US
Practice Address - Phone:410-760-4500
Practice Address - Fax:410-761-5035
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MDD41264207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB93063Medicare UPIN