Provider Demographics
NPI:1831105550
Name:BARNWELL, JOHN MACLIN SR (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MACLIN
Last Name:BARNWELL
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:18709 MEYERS
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-864-8456
Mailing Address - Fax:313-864-0079
Practice Address - Street 1:18709 MEYERS RD.
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-864-8456
Practice Address - Fax:313-864-0079
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIJB0719442086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3500585Medicaid
F96124Medicare UPIN