Provider Demographics
NPI:1407960867
Name:BARRON, MICHELLE ANGELIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANGELIQUE
Last Name:BARRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1544 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1347
Mailing Address - Country:US
Mailing Address - Phone:303-321-0172
Mailing Address - Fax:303-315-8681
Practice Address - Street 1:4200 E NINTH AVE # B168
Practice Address - Street 2:SCHOOL OF MEDICINE, ROOM 1621-A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80262-0001
Practice Address - Country:US
Practice Address - Phone:303-315-1113
Practice Address - Fax:303-315-8681
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39148207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
H43074Medicare UPIN