Provider Demographics
NPI:1124003645
Name:HARBAUGH, CYNTHIA SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:SUE
Last Name:HARBAUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2147 RIVERCHASE OFFICE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1836
Mailing Address - Country:US
Mailing Address - Phone:205-403-8902
Mailing Address - Fax:205-421-2109
Practice Address - Street 1:6631 PARK DR
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-5227
Practice Address - Country:US
Practice Address - Phone:251-626-5700
Practice Address - Fax:251-626-5703
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2011-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL19789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51031513OtherBLUE CROSS & BLUE SHEILD
ALE75244Medicare UPIN
AL000031513Medicare ID - Type Unspecified