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NPI Code Detail

MEDICARE: SUSAN M BARNHARDT PAC

MEDICARE: SUSAN M BARNHARDT PAC
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
1363AS0400XSurgical Physician Assistant
2363A00000XPhysician Assistant
3363AM0700XMedical Physician Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11021772OTHERMINCCPA CERTIFICATE NUMBER
25601001978OTHERMISTATE LICENSE

General Provider Information

NPI Number : 1598702540
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN M BARNHARDT PAC
Provider Business Mailing Address
First Line : 5656 W US HIGHWAY 10
Second Line :
City : LUDINGTON
State : MI
Zip : 49431-2454
Country : US
Telephone Number : 231-843-2543
Fax Number : 231-843-2547
Provider Business Practice Location Address
First Line : 5656 W US HIGHWAY 10
Second Line :
City : LUDINGTON
State : MI
Zip : 49431-2454
Country : US
Telephone Number : 231-843-2543
Fax Number : 231-843-2547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 04/17/2023

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Directions to “ SUSAN M BARNHARDT PAC” Practice Location

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