Individual
BRUCE STEPHEN BARBOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 E MICHIGAN AVE, STE 106, JACKSON, MI 49201-2457
(517) 787-1995
(517) 789-8657
Mailing address
900 E MICHIGAN AVE, STE 106, JACKSON, MI 49201-2457
(517) 787-1995
(517) 789-8657
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301053463
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104492530
—
MI
01
—
110107482
RAILROAD MEDICARE
MI
01
—
1103802101
BCBSM
MI
Enumeration date
05/03/2006
Last updated
08/27/2009
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