Provider Demographics
NPI:1104091230
Name:ROBERT D BARGER, MD, PC
Entity type:Organization
Organization Name:ROBERT D BARGER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-935-1885
Mailing Address - Street 1:4020 COPPER VW STE 118
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7041
Mailing Address - Country:US
Mailing Address - Phone:231-935-1885
Mailing Address - Fax:231-935-1886
Practice Address - Street 1:4020 COPPER VW STE 118
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7041
Practice Address - Country:US
Practice Address - Phone:231-935-1885
Practice Address - Fax:231-935-1886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010598612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7000022012OtherPRIORITY HEALTH
MI2602810371OtherBLUE CROSS BLUE SHIELD OF MI
MION99130Medicare PIN