Provider Demographics
NPI:1316915069
Name:POLSTEIN, BARBARA (DO)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:POLSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:POLSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:824 S SAN FRANSISCO ST
Mailing Address - Street 2:BLDG 25 NAU CAMPUS
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86011-0001
Mailing Address - Country:US
Mailing Address - Phone:928-523-2131
Mailing Address - Fax:928-523-4411
Practice Address - Street 1:824 S SAN FRANSISCO ST
Practice Address - Street 2:BLDG 25 NAU CAMPUS
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86011-0001
Practice Address - Country:US
Practice Address - Phone:928-523-2131
Practice Address - Fax:928-523-1102
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ113554Medicare PIN
AZG36159Medicare UPIN