Provider Demographics
NPI:1659324994
Name:BARI, ABDUL (MD)
Entity type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:
Last Name:BARI
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 1:618 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GA
Mailing Address - Zip Code:39828-2228
Mailing Address - Country:US
Mailing Address - Phone:229-377-7090
Mailing Address - Fax:229-377-6936
Practice Address - Street 1:618 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GA
Practice Address - Zip Code:39828-2228
Practice Address - Country:US
Practice Address - Phone:229-377-7090
Practice Address - Fax:229-377-6936
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA043866207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000769271GMedicaid
GA1659324994Medicare UPIN
GA000769271GMedicaid
GAG63764Medicare UPIN