Provider Demographics
NPI:1619978590
Name:SWEDLOW, BARRY LEONARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:LEONARD
Last Name:SWEDLOW
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3623 OLD FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2906
Mailing Address - Country:US
Mailing Address - Phone:434-385-9393
Mailing Address - Fax:434-385-6587
Practice Address - Street 1:3623 OLD FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2906
Practice Address - Country:US
Practice Address - Phone:434-385-9393
Practice Address - Fax:434-385-6587
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000266213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT21796Medicare UPIN