Provider Demographics
NPI:1457713455
Name:AUGUSTA CANCER DIAGNOSTICS
Entity Type:Organization
Organization Name:AUGUSTA CANCER DIAGNOSTICS
Other - Org Name:CATHERINE BARRY DO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-569-2942
Mailing Address - Street 1:16 IVY RIDGE LN
Mailing Address - Street 2:SUITE 138
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2354
Mailing Address - Country:US
Mailing Address - Phone:540-569-2942
Mailing Address - Fax:540-688-2994
Practice Address - Street 1:16 IVY RIDGE LN
Practice Address - Street 2:SUITE 138
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2354
Practice Address - Country:US
Practice Address - Phone:540-569-2942
Practice Address - Fax:540-688-2994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207ZD0900X
VA0102203334207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathologyGroup - Single Specialty