Healthcare Provider Details

I. General information

NPI: 1881636595
Provider Name (Legal Business Name): NANCY B BARR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 FRANKLIN SQUARE DR STE 205
ROSEDALE MD
21237-3975
US

IV. Provider business mailing address

9101 FRANKLIN SQUARE DR STE 205
ROSEDALE MD
21237-3975
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-2000
  • Fax:
Mailing address:
  • Phone: 443-777-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA70364
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD68398
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: