Provider Demographics
NPI:1013046994
Name:BARNWELL-GRAYSON, ANNE B (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:B
Last Name:BARNWELL-GRAYSON
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 1:225 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2228
Mailing Address - Country:US
Mailing Address - Phone:276-236-6906
Mailing Address - Fax:276-236-7179
Practice Address - Street 1:225 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2228
Practice Address - Country:US
Practice Address - Phone:276-236-6906
Practice Address - Fax:276-236-7179
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2004-0707208600000X
VA0101040250208600000X
NMMD2004-0707208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
34372001Medicare PIN
E75122Medicare UPIN