MEDICARE: DR. BARRY STEVEN TATAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D0033303	MD
2	207Y00000X	Otolaryngology Physician	D33303	MD
3	207Y00000X	Otolaryngology Physician	D0033303	MD

General Provider Information

NPI Number	:	1386639466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY STEVEN TATAR M.D.

Provider Business Mailing Address
First Line	:	8178 LARK BROWN RD.
Second Line	:	SUITE 101
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6438
Country	:	US
Telephone Number	:	410-799-3940
Fax Number	:	410-799-3944

Provider Business Practice Location Address
First Line	:	8178 LARK BROWN RD.
Second Line	:	SUITE 101
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6438
Country	:	US
Telephone Number	:	410-799-3940
Fax Number	:	410-799-3944

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	09/12/2011

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