Provider Demographics
NPI:1073733051
Name:BARBUS, CAROLYN M (PA-C)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:BARBUS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:53880 CARMICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1567
Mailing Address - Country:US
Mailing Address - Phone:574-247-9441
Mailing Address - Fax:574-247-9442
Practice Address - Street 1:53880 CARMICHAEL DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1567
Practice Address - Country:US
Practice Address - Phone:574-247-9441
Practice Address - Fax:574-247-9442
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2015-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10000240363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant