Provider Demographics
NPI:1700636511
Name:DYER, BARBARA PETRANELLA (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:PETRANELLA
Last Name:DYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NELLIE
Other - Middle Name:
Other - Last Name:DYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2603 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64501-2644
Mailing Address - Country:US
Mailing Address - Phone:816-294-1988
Mailing Address - Fax:
Practice Address - Street 1:2603 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-2644
Practice Address - Country:US
Practice Address - Phone:816-294-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program