Healthcare Provider Details

I. General information

NPI: 1588615512
Provider Name (Legal Business Name): BARBARA D SAXENA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 10/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 CHARLEVOIX DR SUITE 180
GRAND LEDGE MI
48837-8186
US

IV. Provider business mailing address

PO BOX 80227
LANSING MI
48908-0227
US

V. Phone/Fax

Practice location:
  • Phone: 517-622-1814
  • Fax: 517-622-0694
Mailing address:
  • Phone: 517-622-1814
  • Fax: 517-622-0694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBS060808
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: