Provider Demographics
NPI:1730224320
Name:BARNES, MAURICE C (MD)
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:C
Last Name:BARNES
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 1:1429 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-1019
Mailing Address - Country:US
Mailing Address - Phone:812-242-3390
Mailing Address - Fax:812-242-3384
Practice Address - Street 1:1429 N 6TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-1019
Practice Address - Country:US
Practice Address - Phone:812-242-3390
Practice Address - Fax:812-242-3384
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000012445174400000X
OH35.143256207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3180286Medicare PIN
TND32130Medicare UPIN