Blue Water Physiatry L L C

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

D0039416 Issued in MD

Legal business name

BLUE WATER PHYSIATRY L L C

Practice address

7501 Surratts Road
#202
Clinton, MD 20735-2256

Phone

(301) 877-6110

Fax

(301) 877-2695

NPI assigned

Nov 21, 2007

Organization subpart

Yes

Parent organization

BLUE WATER PHYSIATRY L L CAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Arthur Peter Barletta, MD

Title

President

Phone

(301) 877-6110

Specialties & licenses 2

Addresses

Part of

Blue Water Physiatry L L C

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1770764490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6368 COVENTRY WAY",
            "address_2": "#365",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352256",
            "telephone_number": "301-877-6110",
            "fax_number": "301-877-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 SURRATTS ROAD",
            "address_2": "#202",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352256",
            "telephone_number": "301-877-6110",
            "fax_number": "301-877-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER PHYSIATRY L L C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE WATER PHYSIATRY L L C",
        "enumeration_date": "2007-11-21",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "BARLETTA",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-877-6110",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D0039416",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MD",
            "license": "D0039416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bleach and Associates, LLC
• Gail Bleach, PH.D.
• Seymour Howard Bloom, DDS
• Blooms Health Care Services LLC
• Blossom Home Care Services LLC
• Shannon Bondoc
• Marian E Booker
• Girard Boulware
• Maryam Boumezrag, MD
• Camille Boustani, MD

• Physical Medicine & Rehabilitation Physician in Clinton, MD
• Providers in Clinton, MD by specialty
• Physical Medicine & Rehabilitation Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.