Provider Demographics
NPI:1760440721
Name:ALLISON-BRYAN, BARBARA ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANNE
Last Name:ALLISON-BRYAN
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 1:5659 PARKWAY DR
Mailing Address - Street 2:STE 230
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-3782
Mailing Address - Country:US
Mailing Address - Phone:804-210-1055
Mailing Address - Fax:804-210-1059
Practice Address - Street 1:5659 PARKWAY DR
Practice Address - Street 2:STE 230
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-3782
Practice Address - Country:US
Practice Address - Phone:804-210-1055
Practice Address - Fax:804-210-1059
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042194208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1200493OtherUNITEDHEALTH CARE NUMBER
VA17423OtherOPTIMA PROVIDER NUMBER
VA095242OtherBCBS NUMBER
VAVA6747442Medicaid
VA101341OtherCIGNA NUMBER
VA17423OtherOPTIMA PROVIDER NUMBER