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General NPI Number Information
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NPI Number | 1891743191
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Entity Type | Individual
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Provider Name | ALLAN WALTER BARBISH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 3304 COOLEY CT
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City | PORTAGE
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State | MI
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Zip | 49024
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Country | US
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Telephone | 269-349-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 3304 COOLEY CT
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City | PORTAGE
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State | MI
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Zip | 49024-7430
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Country | US
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Telephone | 269-349-2266
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301406927
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 01040132
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301406927
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License Number State | MI
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