Healthcare Provider Details

I. General information

NPI: 1619978723
Provider Name (Legal Business Name): EDWARD NELSON BARR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 E LINCOLNWAY
MINERVA OH
44657-1216
US

IV. Provider business mailing address

3515 MASSILLON RD STE 300
UNIONTOWN OH
44685-7854
US

V. Phone/Fax

Practice location:
  • Phone: 330-868-6044
  • Fax:
Mailing address:
  • Phone: 330-899-9350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35048956B
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: