Provider Demographics
NPI:1629365168
Name:LEONARD G. BARMAK, MD, PC
Entity Type:Organization
Organization Name:LEONARD G. BARMAK, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:BARMAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:703-978-8100
Mailing Address - Street 1:9000 CROWNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1630
Mailing Address - Country:US
Mailing Address - Phone:703-978-8100
Mailing Address - Fax:703-978-8101
Practice Address - Street 1:9000 CROWNWOOD CT
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1630
Practice Address - Country:US
Practice Address - Phone:703-978-8100
Practice Address - Fax:703-978-8101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101028001174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA177631Medicare UPIN