Provider Demographics
NPI:1962407742
Name:BARNOVSKY, DAVID A (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:BARNOVSKY
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 1:4768 STATE ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-8614
Mailing Address - Country:US
Mailing Address - Phone:330-301-0829
Mailing Address - Fax:
Practice Address - Street 1:4768 STATE ROUTE 46
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-8614
Practice Address - Country:US
Practice Address - Phone:330-301-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.002680213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1150718Medicaid
OH1150718Medicaid