Provider Demographics
NPI:1316077266
Name:BARRETT, MATTHEW LAWRENCE (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LAWRENCE
Last Name:BARRETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:22 S GREENE ST
Mailing Address - Street 2:BOX 353
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1544
Mailing Address - Country:US
Mailing Address - Phone:410-328-0978
Mailing Address - Fax:410-328-2088
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:BOX 353
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-0978
Practice Address - Fax:410-328-2088
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC70003471207P00000X
DEC7-0003471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine