Individual
DR. BARNETT G MENNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1880 HOWARD AVE, SUITE 300, VIENNA, VA 22182-2667
(703) 790-0103
(790) 703-0379
Mailing address
1880 HOWARD AVE, SUITE 300, VIENNA, VA 22182-2667
(703) 790-0103
(703) 790-0379
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0072173
MD
208000000X
Pediatrics Physician
D0072173
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101248289
STATE LICENSE
VA
01
—
D0072173
STATE LICENSE
MD
Enumeration date
04/12/2007
Last updated
04/02/2015
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