Provider Demographics
NPI:1144295510
Name:BARNA, MARY ELAINE (DPM PA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELAINE
Last Name:BARNA
Suffix:
Gender:F
Credentials:DPM PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 998
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-0998
Mailing Address - Country:US
Mailing Address - Phone:248-581-4437
Mailing Address - Fax:313-636-2320
Practice Address - Street 1:7445 ALLEN RD
Practice Address - Street 2:SUITE 280
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1963
Practice Address - Country:US
Practice Address - Phone:313-388-9205
Practice Address - Fax:313-388-9264
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001379213E00000X
MI5601002407363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI480006536OtherRR MEDICARE
MI480F372880OtherBLUE CROSS BLUE SHIELD
MI0P06380002OtherMEDICARE NUMBER
MI1896340Medicaid
MI480006536OtherRR MEDICARE
MI1896340Medicaid
MI0P06370002Medicare PIN