Provider Demographics
NPI:1730250531
Name:SILBAUGH, BARRY ROGER (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ROGER
Last Name:SILBAUGH
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 1:51 PINON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:SANDIA PARK
Mailing Address - State:NM
Mailing Address - Zip Code:87047-9301
Mailing Address - Country:US
Mailing Address - Phone:505-286-2210
Mailing Address - Fax:505-286-2211
Practice Address - Street 1:235 ELM ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3672
Practice Address - Country:US
Practice Address - Phone:505-767-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM73-209207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine