Provider Demographics
NPI:1790768448
Name:SUMBATIAN, BARBARA (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SUMBATIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:3 FLOWERS DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1701
Practice Address - Country:US
Practice Address - Phone:717-612-1830
Practice Address - Fax:717-612-1850
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4183052084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018965560006Medicaid
PA260051920OtherRAIL ROAD MEDICARE
PA7133477OtherAETNA
PA1999839OtherFIRST HEALTH
PA50030573OtherCAPITAL BLUE CROSS
PA1387422OtherHIGHMARK BLUE SHIELD
PA001896560001Medicaid
PA001896560001Medicaid
PA58390GXPMedicare PIN
PA1387422OtherHIGHMARK BLUE SHIELD