Provider Demographics
NPI:1275554073
Name:BARKER, WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:BARKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30795 23 MILE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-5720
Mailing Address - Country:US
Mailing Address - Phone:586-421-3150
Mailing Address - Fax:586-421-3151
Practice Address - Street 1:30795 23 MILE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-5720
Practice Address - Country:US
Practice Address - Phone:586-421-3150
Practice Address - Fax:586-421-3151
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4320330Medicaid
0E06280033Medicare PIN
MI4320330Medicaid