Provider Demographics
NPI:1720062409
Name:BARFIELD, WANDA DENISE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:WANDA
Middle Name:DENISE
Last Name:BARFIELD
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 LAVISTA RD STE E
Mailing Address - Street 2:#199
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5162
Mailing Address - Country:US
Mailing Address - Phone:404-634-6854
Mailing Address - Fax:404-634-6854
Practice Address - Street 1:850 HARRISON AVE # YACC6
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4001
Practice Address - Country:US
Practice Address - Phone:617-414-4841
Practice Address - Fax:617-414-7297
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0492682080N0001X
MA770562080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF88002Medicare UPIN