Provider Demographics
NPI:1174539167
Name:BARTON, EDWARD E (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:E
Last Name:BARTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26850 PROVIDENCE PARKWAY
Mailing Address - Street 2:STE 470
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374
Mailing Address - Country:US
Mailing Address - Phone:248-319-3000
Mailing Address - Fax:248-319-3001
Practice Address - Street 1:26850 PROVIDENCE PARKWAY
Practice Address - Street 2:STE 470
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374
Practice Address - Country:US
Practice Address - Phone:248-319-3000
Practice Address - Fax:248-319-3001
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301043346208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0630378Medicare ID - Type Unspecified
B47412Medicare UPIN