Provider Demographics
NPI:1265652572
Name:BARNEY, SHARYN (MD)
Entity Type:Individual
Prefix:
First Name:SHARYN
Middle Name:
Last Name:BARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MOOSE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55767-9449
Mailing Address - Country:US
Mailing Address - Phone:218-485-5050
Mailing Address - Fax:218-485-5008
Practice Address - Street 1:1000 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:MOOSE LAKE
Practice Address - State:MN
Practice Address - Zip Code:55767-9449
Practice Address - Country:US
Practice Address - Phone:218-485-5050
Practice Address - Fax:218-485-5008
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNB51373Medicare UPIN