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NPI Code Detail

MEDICARE: SUSAN S BARNES, D.O., P.C.

MEDICARE: SUSAN S BARNES, D.O., P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MI1021OTHERMIMEDICARE IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1053567198
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUSAN S BARNES, D.O., P.C.
Provider Business Mailing Address
First Line : PO BOX 404
Second Line :
City : CLARKSTON
State : MI
Zip : 48347-0404
Country : US
Telephone Number : 248-535-0955
Fax Number :
Provider Business Practice Location Address
First Line : 585 E FLINT ST
Second Line :
City : LAKE ORION
State : MI
Zip : 48362-3209
Country : US
Telephone Number : 248-693-0505
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. SUSAN SEYMOUR BARNES
Credential : D.O.
Telephone Number : 248-535-0955
Provider Enumeration Date : 08/08/2008
Last Update Date : 10/04/2013

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