Healthcare Provider Details
I. General information
NPI: 1083629471
Provider Name (Legal Business Name): SHERRY T BARINOWSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
465 N BELAIR RD SUITE 1C
EVANS GA
30809-3188
US
IV. Provider business mailing address
465 N BELAIR RD SUITE 1C
EVANS GA
30809-3188
US
V. Phone/Fax
- Phone: 706-854-2160
- Fax: 706-854-2930
- Phone: 706-854-2160
- Fax: 706-854-2930
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 042521 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: