Provider Demographics
NPI:1053376244
Name:BARTA, PATRICK ERNEST (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ERNEST
Last Name:BARTA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E CHESAPEAKE AVE
Mailing Address - Street 2:#401
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5338
Mailing Address - Country:US
Mailing Address - Phone:443-470-9101
Mailing Address - Fax:410-337-8084
Practice Address - Street 1:101 E CHESAPEAKE AVE
Practice Address - Street 2:#401
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5338
Practice Address - Country:US
Practice Address - Phone:443-470-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD347882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD538731100Medicaid
MDE16572Medicare UPIN
MD538731100Medicaid