Healthcare Provider Details

I. General information

NPI: 1144295510
Provider Name (Legal Business Name): MARY ELAINE BARNA DPM PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7445 ALLEN RD SUITE 280
ALLEN PARK MI
48101-1963
US

IV. Provider business mailing address

PO BOX 998
ALLEN PARK MI
48101-0998
US

V. Phone/Fax

Practice location:
  • Phone: 313-388-9205
  • Fax: 313-388-9264
Mailing address:
  • Phone: 248-581-4437
  • Fax: 313-636-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5901001379
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601002407
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: