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General NPI Number Information
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NPI Number | 1336179506
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Entity Type | Individual
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Provider Name | BARRY BEAN DPM
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 21721 W 11 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48076-3717
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Country | US
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Telephone | 248-355-4888
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Fax | 313-355-2565
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Provider Business Mailing Address
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Address Line | 21721 W 11 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48076-3717
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Country | US
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Telephone | 248-355-4888
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Fax | 313-355-2565
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | BB000712
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License Number State | MI
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