Provider Demographics
NPI:1558736033
Name:BAARSON, MYLES C
Entity Type:Individual
Prefix:
First Name:MYLES
Middle Name:C
Last Name:BAARSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31330 SCHOOLCRAFT RD
Mailing Address - Street 2:STE 200
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-2041
Mailing Address - Country:US
Mailing Address - Phone:734-525-9712
Mailing Address - Fax:
Practice Address - Street 1:31330 SCHOOLCRAFT RD
Practice Address - Street 2:STE 200
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-2041
Practice Address - Country:US
Practice Address - Phone:734-525-9712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic