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Organization

BLUE WATER PHYSIATRY L L C

Active
Parent organization
BLUE WATER PHYSIATRY L L C
Organization subpart
Yes

Provider details

NPI number
Legal business name
BLUE WATER PHYSIATRY L L C
Authorized official
ARTHUR PETER BARLETTA MD (PRESIDENT)
(301) 877-6110
Entity
Organization

Contact information

Practice address
7501 SURRATTS ROAD, #202, CLINTON, MD 20735-2256
(301) 877-6110
(301) 877-2695
Mailing address
6368 COVENTRY WAY, #365, CLINTON, MD 20735-2256
(301) 877-6110
(301) 877-2695

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D0039416
MD
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
D0039416
MD

Other

Enumeration date
11/21/2007
Last updated
02/14/2012
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