Provider Demographics
NPI:1316943384
Name:BARRO, LEE DENNIS (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:DENNIS
Last Name:BARRO
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 1:991 W HUDSON BLVD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-6430
Mailing Address - Country:US
Mailing Address - Phone:704-853-5294
Mailing Address - Fax:704-853-5269
Practice Address - Street 1:119 W PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BESSEMER CITY
Practice Address - State:NC
Practice Address - Zip Code:28016-2635
Practice Address - Country:US
Practice Address - Phone:704-629-3465
Practice Address - Fax:704-629-1355
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913558Medicaid
NC8913558Medicaid
NCC81353Medicare UPIN