Provider Demographics
NPI:1861484875
Name:HEMENWAY, BARBARA G (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:G
Last Name:HEMENWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1500 N 34TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-4477
Mailing Address - Country:US
Mailing Address - Phone:715-395-5380
Mailing Address - Fax:715-394-2682
Practice Address - Street 1:4325 GRAND AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55807-2730
Practice Address - Country:US
Practice Address - Phone:218-722-1497
Practice Address - Fax:218-722-6239
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI63197207Q00000X
MN23548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080024252OtherRAILROAD MEDICARE
MN738392400Medicaid
MN080024252OtherRAILROAD MEDICARE
MNH400120937Medicare PIN