MEDICARE: JEAN MARIE DE BARROS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-02161	NC

General Provider Information

NPI Number	:	1629153846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN MARIE DE BARROS PA

Provider Business Mailing Address
First Line	:	PO BOX 360
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-0360
Country	:	US
Telephone Number	:	888-339-6065
Fax Number	:	828-538-4441

Provider Business Practice Location Address
First Line	:	6051 TYVOLA GLEN CIR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-6431
Country	:	US
Telephone Number	:	704-774-6569
Fax Number	:	855-308-2340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	11/25/2025

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Directions to “ JEAN MARIE DE BARROS PA” Practice Location

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