Provider Demographics
NPI:1588615512
Name:SAXENA, BARBARA D (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:D
Last Name:SAXENA
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:PO BOX 80227
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48908-0227
Mailing Address - Country:US
Mailing Address - Phone:517-622-1814
Mailing Address - Fax:517-622-0694
Practice Address - Street 1:1005 CHARLEVOIX DR
Practice Address - Street 2:SUITE 180
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-8186
Practice Address - Country:US
Practice Address - Phone:517-622-1814
Practice Address - Fax:517-622-0694
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBS060808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4086317Medicaid
MI0802300382OtherBLUE CARE NETWORK
MI0802300382OtherBCBSM
MI0802300382OtherBLUE CARE NETWORK
MI0P01370Medicare ID - Type Unspecified
MI4086317Medicaid