Healthcare Provider Details

I. General information

NPI: 1689664005
Provider Name (Legal Business Name): RYAN H BARISH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CORPORATE OFFICE DR STE 100
MILFORD MI
48381-5011
US

IV. Provider business mailing address

1100 CORPORATE OFFICE DR STE 100
MILFORD MI
48381-5011
US

V. Phone/Fax

Practice location:
  • Phone: 248-985-7900
  • Fax: 248-925-4087
Mailing address:
  • Phone: 248-985-7900
  • Fax: 248-925-4087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301078264
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: