Provider Demographics
NPI:1336154772
Name:JOHN M BARNWELL MD PLLC
Entity Type:Organization
Organization Name:JOHN M BARNWELL MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MACLIN
Authorized Official - Last Name:BARNWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:313-864-8456
Mailing Address - Street 1:18709 MEYERS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1310
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:48235-1310
Practice Address - Country:US
Practice Address - Phone:313-864-8456
Practice Address - Fax:313-864-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJB0719442086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty