MEDICARE: DR. FERMIN BARRUETO JR. 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	208D00000X	General Practice Physician	D0057223	MD
2	174400000X	Specialist	D0057223	MD
3	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	D57223	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548248818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERMIN BARRUETO JR. M.D.

Provider Business Mailing Address
First Line	:	12844 STONE EAGLE RD
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-2317
Country	:	US
Telephone Number	:	443-465-4289
Fax Number	:

Provider Business Practice Location Address
First Line	:	1099 WINTERSON RD STE 300
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-2279
Country	:	US
Telephone Number	:	800-905-3261
Fax Number	:

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	02/04/2026

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Directions to “ DR. FERMIN BARRUETO JR. M.D.” Practice Location

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