Provider Demographics
NPI:1336170984
Name:BARRY, NANCY-NICHOLE (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY-NICHOLE
Middle Name:
Last Name:BARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:N. NICHOLE
Other - Middle Name:
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:116 NORTHPORT AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6096
Mailing Address - Country:US
Mailing Address - Phone:207-505-4015
Mailing Address - Fax:207-338-8368
Practice Address - Street 1:116 NORTHPORT AVE STE 220
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6096
Practice Address - Country:US
Practice Address - Phone:207-505-4015
Practice Address - Fax:207-338-8368
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79187207RR0500X
MEMD28601207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F72074Medicare UPIN