Provider Demographics
NPI:1679591325
Name:BARNES, DENICE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENICE
Middle Name:MARIE
Last Name:BARNES
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 1:404 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 306 PENNS SQUARE
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1897
Mailing Address - Country:US
Mailing Address - Phone:215-269-3330
Mailing Address - Fax:215-269-3355
Practice Address - Street 1:404 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 306 PENNS SQUARE
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1897
Practice Address - Country:US
Practice Address - Phone:215-269-3330
Practice Address - Fax:215-269-3355
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038353E2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011042890002Medicaid
PA1054367OtherKEYSTONE MERCY
PA233044033OtherTAX ID
PA540OtherUSHC
PABA158781OtherBLUE SHIELD
PA158781OtherKEYSTONE HEALTH PLAN EAST
PA0110428903OtherAMERICHOICE
PABUP093OtherOXFORD
PABA158781OtherBLUE SHIELD