Provider Demographics
NPI:1013948702
Name:BARSOUM, MAHER (DC)
Entity Type:Individual
Prefix:DR
First Name:MAHER
Middle Name:
Last Name:BARSOUM
Suffix:
Gender:M
Credentials:DC
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 1534
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357
Mailing Address - Country:US
Mailing Address - Phone:517-546-4680
Mailing Address - Fax:
Practice Address - Street 1:1181 NORTH MILFORD RD.
Practice Address - Street 2:SUITE 205
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381
Practice Address - Country:US
Practice Address - Phone:517-546-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950D710890OtherBCBS-MICHIGAN