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General NPI Number Information
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NPI Number | 1578192167
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Entity Type | Individual
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Provider Name | MICHAEL GRAY BARDEN DO
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Gender | Male
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Dates
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Enumeration Date | 04/06/2020
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 1505 W SHERMAN AVE
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City | VINELAND
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State | NJ
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Zip | 08360-7059
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Country | US
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Telephone | 856-641-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4598 NW 25TH WAY
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City | BOCA RATON
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State | FL
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Zip | 33434-2505
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Country | US
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Telephone | 561-212-1927
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MB12265300
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MB12265300
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License Number State | FL
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