Individual
DR. JEREMY DAVID BARBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4100 LAKE DR SE STE 205, GRAND RAPIDS, MI 49546-8292
(616) 267-7414
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101016770
MI
207RG0100X
Gastroenterology Physician
Primary
5101016770
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI1763
MEDICARE GROUP PTAN
MI
Enumeration date
04/26/2007
Last updated
03/10/2021
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