Basic Information
| Provider Information | |||||||||
| NPI: | 1730355249 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARKHAM | ||||||||
| FirstName: | JOHNATHAN | ||||||||
| MiddleName: | EDWARD WALTER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2215 FULLER RD | ||||||||
| Address2: | ANN ARBOR VA HOSPITAL | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481052303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347697100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2215 FULLER RD | ||||||||
| Address2: | ANN ARBOR VA HOSPITAL | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481052303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347697100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2008 | ||||||||
| LastUpdateDate: | 11/26/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 5315055471 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RS0012X | 5315055471 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
No ID Information.