Provider Demographics
NPI:1558370148
Name:BARILE, ANGELO M (MD)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:M
Last Name:BARILE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24651 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5635
Mailing Address - Country:US
Mailing Address - Phone:440-895-5056
Mailing Address - Fax:
Practice Address - Street 1:15000 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4014
Practice Address - Country:US
Practice Address - Phone:216-227-9964
Practice Address - Fax:216-226-3917
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35087157207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2653838Medicaid
OHP00335714OtherMEDICARE RAILROAD
OH2653838Medicaid
OHH415220Medicare PIN
OHP00335714OtherMEDICARE RAILROAD