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General NPI Number Information
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NPI Number | 1710166400
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Entity Type | Organization
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Legal Business Name | RONALD C BARRY
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 4677 TOWNE CTR STE 105
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City | SAGINAW
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State | MI
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Zip | 48604-2846
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Country | US
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Telephone | 989-791-1634
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Fax | 989-791-0428
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Provider Business Mailing Address
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Address Line | 4677 TOWNE CTR STE 105
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City | SAGINAW
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State | MI
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Zip | 48604-2846
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Country | US
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Telephone | 989-791-1634
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Fax | 989-791-0428
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Authorized Official
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Title or Position | OWNER
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Name | RONALD C BARRY
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Credential |
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Telephone | 989-791-1634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 4301048769
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License Number State | MI
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