Provider Demographics
NPI:1891758496
Name:BARBANO, EDWARD FRANCIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:FRANCIS
Last Name:BARBANO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8996 BURKE LAKE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1607
Mailing Address - Country:US
Mailing Address - Phone:703-764-2111
Mailing Address - Fax:703-764-1418
Practice Address - Street 1:8996 BURKE LAKE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1607
Practice Address - Country:US
Practice Address - Phone:703-764-2111
Practice Address - Fax:703-764-1418
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101049038207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5828520Medicaid
VA5828520Medicaid
VAF58639Medicare UPIN