Provider Demographics
NPI:1528229945
Name:SKOBLAR, BARRY MICHAEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MICHAEL
Last Name:SKOBLAR
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 RACINE DR STE B
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-8828
Mailing Address - Country:US
Mailing Address - Phone:910-791-6277
Mailing Address - Fax:910-791-6226
Practice Address - Street 1:219 RACINE DR STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8828
Practice Address - Country:US
Practice Address - Phone:910-791-6277
Practice Address - Fax:910-791-6226
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3576103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1811976426OtherGROUP NPI