Provider Demographics
NPI:1366412793
Name:BARNES, MICHAEL E (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:BARNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3887 OKEMOS RD
Mailing Address - Street 2:SUITE A4
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3664
Mailing Address - Country:US
Mailing Address - Phone:517-381-0111
Mailing Address - Fax:517-381-0444
Practice Address - Street 1:3887 OKEMOS RD
Practice Address - Street 2:SUITE A4
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3664
Practice Address - Country:US
Practice Address - Phone:517-381-0111
Practice Address - Fax:517-381-0444
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010100042084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI26OC310410OtherBCBS PROVIDER
MIOM40060003Medicare ID - Type Unspecified
MI26OC310410OtherBCBS PROVIDER