Provider Demographics
NPI:1902893738
Name:BARNARD, DIANA LYNN (MD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:BARNARD
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 1:111 COLCHESTER AVE
Mailing Address - Street 2:FLETCHER ALLEN HEALTH CARE SMITH 262
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1473
Mailing Address - Country:US
Mailing Address - Phone:802-847-1023
Mailing Address - Fax:902-847-2929
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:FLETCHER ALLEN HEALTH CARE SMITH 262
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1473
Practice Address - Country:US
Practice Address - Phone:802-847-1023
Practice Address - Fax:902-847-2929
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420008973207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN0928Medicaid
VT00019853OtherBCBS
VT00019853OtherBCBS
VTVN0928Medicare ID - Type Unspecified