Provider Demographics
NPI:1811008238
Name:BARRY, ATUL (MD)
Entity Type:Individual
Prefix:
First Name:ATUL
Middle Name:
Last Name:BARRY
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 1:411 W TIPTON ST
Mailing Address - Street 2:ATTN: SCHNECK MEDICAL CENTER ANESTHESIA DEPT
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2363
Mailing Address - Country:US
Mailing Address - Phone:812-522-2349
Mailing Address - Fax:
Practice Address - Street 1:411 W TIPTON ST
Practice Address - Street 2:ATTN: SCHNECK MEDICAL CENTER ANESTHESIA DEPT
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2363
Practice Address - Country:US
Practice Address - Phone:812-522-2349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22488207L00000X
NE17196207L00000X
IN01062928A207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100320450Medicaid
IN1942227855OtherRMAYBERRY NPI#
IN100320450BMedicaid
200857280AOtherMEDICAID GROUP
IN249320AOtherMEDICARE PIN MAYBERRY
IN100320450BMedicaid
IN100320450Medicaid
INC68847Medicare UPIN