Provider Demographics
NPI:1164756193
Name:BARBASH, SCOTT ETHAN (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ETHAN
Last Name:BARBASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HARTFORD CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-9015
Mailing Address - Country:US
Mailing Address - Phone:201-819-4570
Mailing Address - Fax:
Practice Address - Street 1:400 RAY C HUNT DR
Practice Address - Street 2:UNIVERSITY OF VIRGINIA DEPARTMENT OF ORTHOPAEDIC SURG
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-2980
Practice Address - Country:US
Practice Address - Phone:434-243-0265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116027090207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine