Provider Demographics
NPI:1255349965
Name:WITMAN, BARRY HUGH (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:HUGH
Last Name:WITMAN
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 1:124 GROCE ST.
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-2514
Mailing Address - Country:US
Mailing Address - Phone:828-245-7626
Mailing Address - Fax:828-245-8830
Practice Address - Street 1:124 GROCE ST.
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-2514
Practice Address - Country:US
Practice Address - Phone:828-245-7626
Practice Address - Fax:828-245-8830
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A7197OtherMEDCOST
017163OtherUNITED
NC126AVOtherBCBS
NC89126AVMedicaid
A52235Medicare UPIN
2279816CMedicare ID - Type Unspecified