Provider Demographics
NPI:1972795508
Name:EBEL, BARBARA MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:MARY
Last Name:EBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:MARY
Other - Last Name:TALWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4435 GULF BREEZE PARKWAY
Mailing Address - Street 2:GOOD SAMARITAN CLINIC
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563
Mailing Address - Country:US
Mailing Address - Phone:850-934-0064
Mailing Address - Fax:850-934-7839
Practice Address - Street 1:4435 GULF BREEZE PARKWAY
Practice Address - Street 2:GOOD SAMARITAN CLINIC
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563
Practice Address - Country:US
Practice Address - Phone:850-934-0064
Practice Address - Fax:850-934-7839
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 68728207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE92938Medicare UPIN