Individual
BARRY ALAN MANDELL
Active
Individual
BARRY ALAN MANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101057334
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006305555
—
VA
01
—
12133
OPTIMA
VA
01
—
243434
ANTHEM
VA
01
—
CN4826
MEDICARE RAILROAD
VA
01
—
DF9144
MEDICARE RAILROAD
VA
Enumeration date
11/30/2005
Last updated
06/05/2008
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