Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101040250 | VA |
N | 208600000X | Surgeon | 0101040250 | VA |
Y | 208200000X | Surgeon | 2004-0707 | NM |
Y | 208600000X | Surgeon | 2004-0707 | NM |
N | 208200000X | Surgeon | MD2004-0707 | NM |
N | 208600000X | Surgeon | MD2004-0707 | NM |
NPI | 1013046994 |
---|---|
Provider Name | Anne B Barnwell-Grayson |
First Address | Galax, VA 24333-2228 |
Second Address | Galax, VA 24333-2228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 11/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E75122 | (02) |