Provider Demographics
NPI:1811927072
Name:BARDEN, NATHAN D (PAC)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:D
Last Name:BARDEN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1035 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2929
Mailing Address - Country:US
Mailing Address - Phone:989-358-0673
Mailing Address - Fax:989-739-2599
Practice Address - Street 1:208 S STATE ST
Practice Address - Street 2:
Practice Address - City:OSCODA
Practice Address - State:MI
Practice Address - Zip Code:48750-1642
Practice Address - Country:US
Practice Address - Phone:989-739-2550
Practice Address - Fax:989-358-3750
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601004795363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant