Provider Demographics
NPI:1932887957
Name:BARBER, TYRONE MALIK
Entity Type:Individual
Prefix:MR
First Name:TYRONE
Middle Name:MALIK
Last Name:BARBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12024 FORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-6003
Mailing Address - Country:US
Mailing Address - Phone:240-601-5119
Mailing Address - Fax:
Practice Address - Street 1:3001 BLADENSBURG RD NE # 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2235
Practice Address - Country:US
Practice Address - Phone:202-635-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator