Provider Demographics
NPI:1164659660
Name:MICHAEL BARAT MD INC.
Entity Type:Organization
Organization Name:MICHAEL BARAT MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-837-6842
Mailing Address - Street 1:830 AMHERST RD NE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8518
Mailing Address - Country:US
Mailing Address - Phone:330-837-6842
Mailing Address - Fax:330-837-6846
Practice Address - Street 1:830 AMHERST RD NE
Practice Address - Street 2:SUITE 208
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8518
Practice Address - Country:US
Practice Address - Phone:330-837-6842
Practice Address - Fax:330-837-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050934B174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0564858Medicaid
OH0564858Medicaid