Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0420011642 | VT |
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME144090 | FL |
NPI | 1154332377 |
---|---|
Provider Name | Dr. Michael J Barnum |
First Address | Belfast, ME 04915-4116 |
Second Address | Tavares, FL 32778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 18/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1015409 | (05) | VT |
G75357 | (02) | VT |