Provider Demographics
NPI:1598951824
Name:BARATTA, PASQUALE D (MD)
Entity Type:Individual
Prefix:DR
First Name:PASQUALE
Middle Name:D
Last Name:BARATTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2435 PLANTATION CENTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5147
Mailing Address - Country:US
Mailing Address - Phone:704-846-1911
Mailing Address - Fax:704-846-1960
Practice Address - Street 1:2435 PLANTATION CENTER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5147
Practice Address - Country:US
Practice Address - Phone:704-846-1911
Practice Address - Fax:704-846-1960
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9300020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC9300020OtherMEDICAL LICENSE
B41309Medicare UPIN