MEDICARE: BARRY ALAN MANDELL MD

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	207W00000X	Ophthalmology Physician	0101057334	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CN4826	OTHER	VA	MEDICARE RAILROAD
4	DF9144	OTHER	VA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12133	OTHER	VA	OPTIMA
3	243434	OTHER	VA	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972587491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY ALAN MANDELL MD

Provider Business Mailing Address
First Line	:	397 LITTLE NECK RD
Second Line	:	3300 SOUTH BLDG STE. 202
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-5765
Country	:	US
Telephone Number	:	757-227-4300
Fax Number	:	757-486-3125

Provider Business Practice Location Address
First Line	:	397 LITTLE NECK RD
Second Line	:	3300 SOUTH BLDG STE. 202
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-5765
Country	:	US
Telephone Number	:	757-227-4300
Fax Number	:	757-486-3125

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	06/05/2008

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Directions to “ BARRY ALAN MANDELL MD” Practice Location

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