Provider Demographics
NPI:1710948195
Name:BARNARD, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:BARNARD
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 1:27 CREEKVIEW CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4800
Mailing Address - Country:US
Mailing Address - Phone:864-627-4101
Mailing Address - Fax:864-627-4035
Practice Address - Street 1:27 CREEKVIEW CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4800
Practice Address - Country:US
Practice Address - Phone:864-627-4101
Practice Address - Fax:864-627-4035
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4912207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC049129Medicaid
SC7169OtherMEDICARE PTAN, ADD'L
SC7169OtherMEDICARE PTAN, ADD'L