Provider Demographics
NPI:1225214646
Name:BARAKAT, MARK RAMI (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RAMI
Last Name:BARAKAT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20201 N SCOTTSDALE HEALTHCARE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4135
Mailing Address - Country:US
Mailing Address - Phone:602-613-5473
Mailing Address - Fax:602-613-5474
Practice Address - Street 1:20201 N SCOTTSDALE HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4134
Practice Address - Country:US
Practice Address - Phone:602-613-5473
Practice Address - Fax:602-613-5474
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ43454207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ532301Medicaid
AZZ166242Medicare PIN