Provider Demographics
NPI:1730143660
Name:BARJA, ROBERTO H (M D)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:H
Last Name:BARJA
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SPARTA RD
Mailing Address - Street 2:
Mailing Address - City:SANDERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31082-1803
Mailing Address - Country:US
Mailing Address - Phone:478-552-9402
Mailing Address - Fax:478-552-0645
Practice Address - Street 1:620 SPARTA RD
Practice Address - Street 2:
Practice Address - City:SANDERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31082-1803
Practice Address - Country:US
Practice Address - Phone:478-552-9402
Practice Address - Fax:478-552-0645
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039020174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00703645BMedicaid
GAG26827Medicare UPIN
GA20BBCXZMedicare PIN
GA1165340001Medicare NSC