Healthcare Provider Details

I. General information

NPI: 1669461166
Provider Name (Legal Business Name): ARTHUR PETER BARLETTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 OXON HILL RD STE 550
OXON HILL MD
20745-1117
US

IV. Provider business mailing address

11350 MCCORMICK RD EXECUTIVE PLAZA 1, SUITE 501
HUNT VALLEY MD
21031-1002
US

V. Phone/Fax

Practice location:
  • Phone: 301-485-7400
  • Fax:
Mailing address:
  • Phone: 301-877-6110
  • Fax: 301-877-2695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number0101043313
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD0039416
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: