Provider Demographics
NPI:1063493708
Name:BATTERSBY, BRIAN JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOHN
Last Name:BATTERSBY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:BRIAN
Other - Middle Name:J
Other - Last Name:BATTERSBY
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:612B MCCARTHY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5231
Mailing Address - Country:US
Mailing Address - Phone:252-635-1788
Mailing Address - Fax:252-635-3053
Practice Address - Street 1:612B MCCARTHY BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5231
Practice Address - Country:US
Practice Address - Phone:252-635-1788
Practice Address - Fax:252-635-3053
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33939174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913783Medicaid
NC13783OtherBCBS GROUP #
NC2327361OtherMEDICARE GROUP #
NC13783OtherBCBS GROUP #
NC2327361OtherMEDICARE GROUP #
NC8913783Medicaid