Provider Demographics
NPI:1679102123
Name:BARAL, ANUPAM (MD)
Entity Type:Individual
Prefix:
First Name:ANUPAM
Middle Name:
Last Name:BARAL
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 1:296 VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:DE
Mailing Address - Zip Code:19950-2428
Mailing Address - Country:US
Mailing Address - Phone:404-403-4714
Mailing Address - Fax:
Practice Address - Street 1:100 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4364
Practice Address - Country:US
Practice Address - Phone:302-422-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0026229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine