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General NPI Number Information
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NPI Number | 1184848525
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Entity Type | Individual
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Provider Name | ERIC BARUA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 131 PROVIDENCE RD STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28207-1235
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Country | US
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Telephone | 47-495-8007
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Fax | 704-626-3272
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Provider Business Mailing Address
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Address Line | 3735 GLENLAKE DR STE 250
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City | CHARLOTTE
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State | NC
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Zip | 28208-6866
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Country | US
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Telephone | 704-749-5800
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Fax | 704-626-3272
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 88619
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2021-00874
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License Number State | NC
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