Provider Demographics
NPI:1063548196
Name:ISRAEL, STEVEN BARRY (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BARRY
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:121 CONGRESSIONAL LN
Mailing Address - Street 2:SUITE 604
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1542
Mailing Address - Country:US
Mailing Address - Phone:301-468-2262
Mailing Address - Fax:301-468-2263
Practice Address - Street 1:121 CONGRESSIONAL LN
Practice Address - Street 2:SUITE 604
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1542
Practice Address - Country:US
Practice Address - Phone:301-468-2262
Practice Address - Fax:301-468-2263
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD350902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC89296Medicare UPIN
MD515359Medicare PIN