Provider Demographics
NPI:1104000314
Name:FIELDS, BARRY GRANT (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:GRANT
Last Name:FIELDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3624 MARKET ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2614
Mailing Address - Country:US
Mailing Address - Phone:215-662-7772
Mailing Address - Fax:215-349-8038
Practice Address - Street 1:3624 MARKET ST
Practice Address - Street 2:SUITE 201
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2614
Practice Address - Country:US
Practice Address - Phone:215-662-7772
Practice Address - Fax:215-349-8038
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD442169207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine