Provider Demographics
NPI:1861627531
Name:BARR, CHARLES E (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:BARR
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 1:1 DNA WAY
Mailing Address - Street 2:MAIL STOP 66
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-4918
Mailing Address - Country:US
Mailing Address - Phone:650-225-4867
Mailing Address - Fax:
Practice Address - Street 1:1 DNA WAY
Practice Address - Street 2:MAIL STOP 66
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-4918
Practice Address - Country:US
Practice Address - Phone:650-225-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-23
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07288600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine