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NPI Code Detail

MEDICARE: MR. NATHAN D. BARDEN P.A.C.

MEDICARE: MR. NATHAN D. BARDEN P.A.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
1363A00000XPhysician Assistant5601004795MI

General Provider Information

NPI Number : 1811927072
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NATHAN D. BARDEN P.A.C.
Provider Business Mailing Address
First Line : 1035 W WASHINGTON AVE
Second Line :
City : ALPENA
State : MI
Zip : 49707-2929
Country : US
Telephone Number : 989-358-0673
Fax Number : 989-739-2599
Provider Business Practice Location Address
First Line : 208 S STATE ST
Second Line :
City : OSCODA
State : MI
Zip : 48750-1642
Country : US
Telephone Number : 989-739-2550
Fax Number : 989-358-3750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 05/09/2022

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