Provider Demographics
NPI:1447239405
Name:BARSANTI, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:BARSANTI
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 1:1501 MAPLE AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2553
Mailing Address - Country:US
Mailing Address - Phone:804-288-7246
Mailing Address - Fax:804-288-7245
Practice Address - Street 1:1501 MAPLE AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2553
Practice Address - Country:US
Practice Address - Phone:804-288-7246
Practice Address - Fax:804-288-7245
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044553174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA431694OtherANTHEM
VA050074938OtherRAILROAD MEDICARE
VA431694OtherANTHEM