Healthcare Provider Details

I. General information

NPI: 1992997779
Provider Name (Legal Business Name): SHIRLEY OTESIA BARR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 2ND ST NW
WASHINGTON DC
20011-1426
US

IV. Provider business mailing address

6200 2ND ST NW
WASHINGTON DC
20011-1426
US

V. Phone/Fax

Practice location:
  • Phone: 202-722-2300
  • Fax: 202-722-2383
Mailing address:
  • Phone: 202-722-2300
  • Fax: 202-722-2383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11834
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number11834
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: