Provider Demographics
NPI:1316913577
Name:LANCE, BARRRY K (MD)
Entity type:Individual
Prefix:
First Name:BARRRY
Middle Name:K
Last Name:LANCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:14201 LAUREL PARK DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5203
Mailing Address - Country:US
Mailing Address - Phone:301-953-2080
Mailing Address - Fax:301-953-3543
Practice Address - Street 1:14201 LAUREL PARK DR
Practice Address - Street 2:SUITE 214
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:301-953-2080
Practice Address - Fax:301-953-3543
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD27733207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC88216Medicare UPIN
MD173135L77Medicare ID - Type UnspecifiedDC METROPOLITIAN MEDICARE
MD055M876EMedicare ID - Type UnspecifiedMD MEDICARE PROVIDER #