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General NPI Number Information
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NPI Number | 1700946928
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Entity Type | Organization
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Legal Business Name | VIKTORIYA BARG DPM PC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 32910 W 13 MILE RD STE. C300
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-1980
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Country | US
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Telephone | 248-996-1020
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Fax | 248-996-1023
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Provider Business Mailing Address
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Address Line | 32910 W 13 MILE RD SUITE C300
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-1980
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Country | US
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Telephone | 248-996-1020
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Fax | 248-996-1023
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Authorized Official
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Title or Position | OWNER AND PHYSICIAN
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Name | DR. VIKTORIYA BARG
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Credential | DPM
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Telephone | 248-996-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5901002190
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901002190
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License Number State | MI
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