Provider Demographics
NPI:1891897369
Name:BARBOSA, SOFIA ISABEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:ISABEL
Last Name:BARBOSA
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 1:1213 REMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-3433
Mailing Address - Country:US
Mailing Address - Phone:843-973-5415
Mailing Address - Fax:833-994-1101
Practice Address - Street 1:1213 REMOUNT RD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-3433
Practice Address - Country:US
Practice Address - Phone:843-973-5415
Practice Address - Fax:833-994-1101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCM763L064OtherMEDICARE
SCG091865551Medicare PIN
SC8248Medicare ID - Type Unspecified11/ INTERNAL MEDICINE