Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35.134156 | OH |
Y | 208600000X | Surgeon | 35.134156 | OH |
N | 208200000X | Surgeon | 4301101043 | MI |
N | 208600000X | Surgeon | 4301101043 | MI |
NPI | 1003179342 |
---|---|
Provider Name | Wesley Richard Barnes |
First Address | Southfield, MI 48033-3849 |
Second Address | Royal Oak, MI 48073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 23/10/2020 |