Provider Demographics
NPI:1467458612
Name:BIZUB, BARBARA JO (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JO
Last Name:BIZUB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 BRIDGES ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2944
Mailing Address - Country:US
Mailing Address - Phone:252-622-4033
Mailing Address - Fax:252-240-3586
Practice Address - Street 1:3722 BRIDGES ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2944
Practice Address - Country:US
Practice Address - Phone:252-622-4033
Practice Address - Fax:252-240-3586
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003290L363AM0700X
NCNC0010-07176363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA970024858OtherPALMETTO GBA(RR MEDICARE)
PAP53914Medicare UPIN