Daniel A Barrett, MD

Individual provider Active NPI Pediatrics Physician · Granger, IN

NPI 1972593440 · NPPES record last updated Aug 2, 2016

Key facts

NPI
1972593440
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
01031708A (IN)
Practice address
52500 Fir Rd
Granger, IN 46530-8579
Phone
(574) 204-7050
Fax
(574) 204-7051
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01031708AINMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01031708A IN Yes

Addresses

Primary practice location

52500 Fir Rd
Granger, IN 46530-8579

Mailing address

52500 Fir Rd
Granger, IN 46530-8579
Phone (574) 204-7050

Other identifiers

IdentifierTypeStateIssuer
100138880MedicaidIN

Other providers in Granger, IN

All providers in Granger, IN · Pediatrics Physician in Indiana

Sources for this page

Verify at the official NPI Registry.