Healthcare Provider Details

I. General information

NPI: 1104813625
Provider Name (Legal Business Name): BARRY J POLITI MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 N 4TH ST
WILMINGTON NC
28401-3450
US

IV. Provider business mailing address

2119 GLOUCESTER PL
WILMINGTON NC
28403-5349
US

V. Phone/Fax

Practice location:
  • Phone: 910-202-8656
  • Fax: 910-202-8680
Mailing address:
  • Phone: 901-337-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number39882
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200601789
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number200601789
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: