Provider Demographics
NPI:1871772848
Name:BARBARA D SAXENA MD PLLC
Entity type:Organization
Organization Name:BARBARA D SAXENA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAXENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-622-1814
Mailing Address - Street 1:PO BOX 80227
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48908-0227
Mailing Address - Country:US
Mailing Address - Phone:517-622-1814
Mailing Address - Fax:517-268-6609
Practice Address - Street 1:1005 CHARLEVOIX DR
Practice Address - Street 2:SUITE 180
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-8186
Practice Address - Country:US
Practice Address - Phone:517-622-1814
Practice Address - Fax:517-268-6609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBS060808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI366766342OtherSS#
MI0802300382OtherBCBS
MIBS060808OtherLIC #
MI4086317Medicaid
MI0802300382OtherBCBS
MIG22241Medicare UPIN
MIBS060808OtherLIC #