MEDICARE: RAYMOND K BARRY D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	S01558	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	KE24	OTHER	MD	BCBS OF MD
2	353259	OTHER	MD	MAMSI
3	2184080	OTHER	MD	AETNA
4	629389	OTHER	MD	ACN
5	0001	OTHER	DC	BCBS OF DC

General Provider Information

NPI Number	:	1952590986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND K BARRY D.C.

Provider Business Mailing Address
First Line	:	8096 EDWIN RAYNOR BLVD STE A
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-6837
Country	:	US
Telephone Number	:	410-360-0014
Fax Number	:	410-360-0064

Provider Business Practice Location Address
First Line	:	8096 EDWIN RAYNOR BLVD STE A
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-6837
Country	:	US
Telephone Number	:	410-360-0014
Fax Number	:	410-360-0064

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	04/25/2012

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