MEDICARE: DR. DAVID WILLIAM BARNES D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OS-007113-L	PA

General Provider Information

NPI Number	:	1366466302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WILLIAM BARNES D.O.

Provider Business Mailing Address
First Line	:	1306 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3606
Country	:	US
Telephone Number	:	215-745-1212
Fax Number	:	215-745-4427

Provider Business Practice Location Address
First Line	:	1306 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3606
Country	:	US
Telephone Number	:	215-745-1212
Fax Number	:	215-745-4427

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	10/13/2011

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