Healthcare Provider Details

I. General information

NPI: 1902285653
Provider Name (Legal Business Name): DAVID BARR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 N 52ND ST STE S-3
PHILADELPHIA PA
19131-4736
US

IV. Provider business mailing address

1395 NW 167TH ST
MIAMI GARDENS FL
33169-5710
US

V. Phone/Fax

Practice location:
  • Phone: 267-930-4858
  • Fax:
Mailing address:
  • Phone: 267-930-4858
  • Fax: 305-393-5989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT209303
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD466266
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: