Provider Demographics
NPI:1770539355
Name:NEMROW, BARRY MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MICHAEL
Last Name:NEMROW
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 GRANT AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3157
Mailing Address - Country:US
Mailing Address - Phone:415-897-7187
Mailing Address - Fax:415-897-7938
Practice Address - Street 1:1223 GRANT AVE
Practice Address - Street 2:SUITE D
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-3157
Practice Address - Country:US
Practice Address - Phone:415-897-7187
Practice Address - Fax:415-897-7938
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2585213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA480025698OtherMEDICARE RAILROAD
CANE1200OtherAETNA
CA0270980001OtherMEDICARE CIGNA NOW NOR
CA000E25851Medicaid
CA480025698OtherMEDICARE RAILROAD