MEDICARE: DR. MICHAEL JEFFREY BARKOVIAK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	118286	MO

General Provider Information

NPI Number	:	1609867142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JEFFREY BARKOVIAK M.D.

Provider Business Mailing Address
First Line	:	11133 DUNN RD
Second Line	:	SUITE 2335
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6119
Country	:	US
Telephone Number	:	314-653-5007
Fax Number	:	314-653-4149

Provider Business Practice Location Address
First Line	:	11133 DUNN RD
Second Line	:	SUITE 2335
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6119
Country	:	US
Telephone Number	:	314-653-5007
Fax Number	:	314-653-4149

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	10/23/2007

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Directions to “ DR. MICHAEL JEFFREY BARKOVIAK M.D.” Practice Location

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