Provider Demographics
NPI:1053550087
Name:BARRY S. TATAR, MD, LLC
Entity type:Organization
Organization Name:BARRY S. TATAR, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TATAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-997-1659
Mailing Address - Street 1:8178 LARK BROWN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6424
Mailing Address - Country:US
Mailing Address - Phone:410-799-3940
Mailing Address - Fax:
Practice Address - Street 1:8178 LARK BROWN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6424
Practice Address - Country:US
Practice Address - Phone:410-799-3940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-15
Last Update Date:2009-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD33303207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty