Provider Demographics
NPI:1053343079
Name:BARKER, DAVID B (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:BARKER
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 1:951 WENDOVER HEIGHTS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3565
Mailing Address - Country:US
Mailing Address - Phone:704-487-4677
Mailing Address - Fax:704-751-3678
Practice Address - Street 1:951 WENDOVER HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3565
Practice Address - Country:US
Practice Address - Phone:704-487-4677
Practice Address - Fax:704-481-8050
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24220208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2340801Medicare ID - Type UnspecifiedMEDICARE GROUP PRICING #
C81218Medicare UPIN
202343DMedicare ID - Type UnspecifiedMEDICARE PART B
202343AMedicare Oscar/Certification