Healthcare Provider Details

I. General information

NPI: 1831140649
Provider Name (Legal Business Name): LISA MICHELLE BARBIERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 BAXTER ST
ATHENS GA
30606-3712
US

IV. Provider business mailing address

634 LINWOOD AVE NE
ATLANTA GA
30306-4441
US

V. Phone/Fax

Practice location:
  • Phone: 706-389-3430
  • Fax:
Mailing address:
  • Phone: 860-798-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number58143
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number026687
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number058143
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number026687
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: