MEDICARE: D. BRADFORD BARKER, MD, PLC

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	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1275527434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D. BRADFORD BARKER, MD, PLC

Provider Business Mailing Address
First Line	:	2333 BIDDLE ST
Second Line	:	REHABILITATION WING
City	:	WYANDOTTE
State	:	MI
Zip	:	48192-4668
Country	:	US
Telephone Number	:	734-246-6046
Fax Number	:	734-324-3618

Provider Business Practice Location Address
First Line	:	2333 BIDDLE ST
Second Line	:	REHABILITATION WING
City	:	WYANDOTTE
State	:	MI
Zip	:	48192-4668
Country	:	US
Telephone Number	:	734-246-6046
Fax Number	:	734-324-3618

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID BRADFORD BARKER
Credential	:	MD
Telephone Number	:	734-246-6046

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	12/21/2010

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