Healthcare Provider Details

I. General information

NPI: 1558341248
Provider Name (Legal Business Name): PATRICK E BAROCO JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 MEDICAL CENTER DR
FISHERSVILLE VA
22939
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-932-4075
  • Fax: 540-932-5199
Mailing address:
  • Phone: 540-932-4075
  • Fax: 540-932-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101236802
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101236802
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number0101236802
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: