=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588664593
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL W BARWICK MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2005
-----------------------------------------------------
Last Update Date | 02/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6701 NORTH CHARLES STREET
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-849-3171
-----------------------------------------------------
Fax | 443-849-8826
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2658 PEERY DRIVE
-----------------------------------------------------
City | CHURCHVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-734-7531
-----------------------------------------------------
Fax | 410-734-7553
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | D58767
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------