MEDICARE: ROBERT D BARGER, MD, PC

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
1	2084P0800X	Psychiatry Physician	4301059861	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7000022012	OTHER		PRIORITY HEALTH
2	2602810371	OTHER	MI	BLUE CROSS BLUE SHIELD OF MI

General Provider Information

NPI Number	:	1104091230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT D BARGER, MD, PC

Provider Business Mailing Address
First Line	:	4020 COPPER VW STE 118
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7041
Country	:	US
Telephone Number	:	231-935-1885
Fax Number	:	231-935-1886

Provider Business Practice Location Address
First Line	:	4020 COPPER VW STE 118
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7041
Country	:	US
Telephone Number	:	231-935-1885
Fax Number	:	231-935-1886

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT D BARGER
Credential	:	MD
Telephone Number	:	231-935-1885

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	04/29/2008

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