Healthcare Provider Details

I. General information

NPI: 1689992190
Provider Name (Legal Business Name): ANDREAS SEBASTIAN BARTH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE MEDICAL HOUSESTAFF PRACTICE
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

675 S PRESIDENT STREET UNIT 1909
BALTIMORE MD
21202-4587
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0530
  • Fax: 410-550-0491
Mailing address:
  • Phone: 410-262-1184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD78770
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberD78770
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: