Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0116027090 | VA |
NPI | 1164756193 |
---|---|
Provider Name | Scott Ethan Barbash |
First Address | Charlottesville, VA 22902-9015 |
Second Address | Charlottesville, VA 22903-2980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2009 |
Last Update Date | 19/05/2015 |