Provider Demographics
NPI:1881823276
Name:GORLITSKY, BARRY R (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:R
Last Name:GORLITSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BARRY
Other - Middle Name:ROSS
Other - Last Name:GORLITSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:203 MILLS AVE
Mailing Address - Street 2:CAROLINA NEPHROLOGY PA
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4019
Mailing Address - Country:US
Mailing Address - Phone:864-271-1844
Mailing Address - Fax:864-271-2147
Practice Address - Street 1:203 MILLS AVE
Practice Address - Street 2:CAROLINA NEPHROLOGY, PA
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4019
Practice Address - Country:US
Practice Address - Phone:864-271-1844
Practice Address - Fax:864-271-2147
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC38606207RN0300X, 207RN0300X
AZ46400207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC386068Medicaid