Healthcare Provider Details

I. General information

NPI: 1497718597
Provider Name (Legal Business Name): MICHAEL D. BARRY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 03/17/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 S MERCY RD SUITE 300
GILBERT AZ
85297-0419
US

IV. Provider business mailing address

7529 E BASELINE SUITE 101
MESA AZ
85208
US

V. Phone/Fax

Practice location:
  • Phone: 480-955-0900
  • Fax: 480-955-0800
Mailing address:
  • Phone: 480-945-4343
  • Fax: 480-945-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2782
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: