Provider Demographics
NPI:1740247162
Name:BARNES, SIDNEY (MD)
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:
Last Name:BARNES
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 1:201 HALL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817
Mailing Address - Country:US
Mailing Address - Phone:410-968-1200
Mailing Address - Fax:410-968-3005
Practice Address - Street 1:201 HALL HIGHWAY
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817
Practice Address - Country:US
Practice Address - Phone:410-968-1200
Practice Address - Fax:410-968-3005
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054422208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
J588Medicare PIN
GC02J588Medicare PIN