Healthcare Provider Details

I. General information

NPI: 1619930211
Provider Name (Legal Business Name): MICHAEL R. BARSOTTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W 8TH AVE SUITE 440
SPOKANE WA
99204-2361
US

IV. Provider business mailing address

35 W 8TH AVE SUITE 440
SPOKANE WA
99204-2361
US

V. Phone/Fax

Practice location:
  • Phone: 509-456-6556
  • Fax:
Mailing address:
  • Phone: 509-456-6556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD00035634
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: