Basic Information
Provider Information
NPI: 1013174275
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARBAS
FirstName: ANDREW
MiddleName: SERGHIOS
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 63362
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282633362
CountryCode: US
TelephoneNumber: 8007826945
FaxNumber:  
Practice Location
Address1: 2301 ERWIN RD
Address2: DUMC BOX 3512
City: DURHAM
State: NC
PostalCode: 277054699
CountryCode: US
TelephoneNumber: 9196848111
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/16/2008
LastUpdateDate: 08/04/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X2014-02226NCY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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