Healthcare Provider Details

I. General information

NPI: 1720062409
Provider Name (Legal Business Name): WANDA DENISE BARFIELD M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HARRISON AVE # YACC6
BOSTON MA
02118-4001
US

IV. Provider business mailing address

3939 LAVISTA RD STE E #199
TUCKER GA
30084-5162
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-4841
  • Fax: 617-414-7297
Mailing address:
  • Phone: 404-634-6854
  • Fax: 404-634-6854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number049268
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number77056
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: