Provider Demographics
NPI:1699872226
Name:DEBARROS, ANTHONY H (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:H
Last Name:DEBARROS
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:PO BOX 105
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02714-0105
Mailing Address - Country:US
Mailing Address - Phone:508-636-6165
Mailing Address - Fax:508-636-6165
Practice Address - Street 1:455 TOLL GATE RD
Practice Address - Street 2:KENT HOSPITAL, RADIOLOGY DEPARTMENT
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2759
Practice Address - Country:US
Practice Address - Phone:401-737-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA389642085R0202X
RIMD046132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB97174Medicare UPIN