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NPI Code Detail

MEDICARE: LANCE BARDEN PA

MEDICARE:   LANCE  BARDEN  PA
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
1363A00000XPhysician Assistant5601004835MI

General Provider Information

NPI Number : 1588765770
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCE BARDEN PA
Provider Business Mailing Address
First Line : 8514 E LINCOLN RD
Second Line :
City : CEDAR
State : MI
Zip : 49621-9453
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1221 SIXTH ST
Second Line : SUITE 202
City : TRAVERSE CITY
State : MI
Zip : 49684-2701
Country : US
Telephone Number : 231-935-5730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 04/16/2021

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Directions to “ LANCE BARDEN PA” Practice Location

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