Provider Demographics
NPI:1245241454
Name:MICHAEL J BARNUM MD,PC
Entity Type:Organization
Organization Name:MICHAEL J BARNUM MD,PC
Other - Org Name:THE SPINE CENTER AT CHESAPEAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARNUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-819-7177
Mailing Address - Street 1:905 BATTLEFIELD BLVD N
Mailing Address - Street 2:STE 103
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4875
Mailing Address - Country:US
Mailing Address - Phone:757-819-7177
Mailing Address - Fax:757-819-7178
Practice Address - Street 1:905 BATTLEFIELD BLVD N
Practice Address - Street 2:STE 103
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4875
Practice Address - Country:US
Practice Address - Phone:757-819-7177
Practice Address - Fax:757-819-7178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207Q00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09584Medicare ID - Type Unspecified