Provider Demographics
NPI:1700863628
Name:BARAM, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:BARAM
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 1:834 WALNUT ST
Mailing Address - Street 2:SUITE 650
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:834 WALNUT STREET SUITE 650
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5595
Practice Address - Country:US
Practice Address - Phone:215-955-6591
Practice Address - Fax:215-955-0830
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429703207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA64732201OtherCARE FIRST BCBS
DE0001123901Medicaid
5865228OtherCIGNA
DE1000038354OtherDELAWARE PHYSICIANS CARE
1121763OtherAETNA/USHC
2623620000OtherINDEPENDENCE BCBS
414303OtherCOVENTRY
NJ0112542Medicaid
PA101767112Medicaid
2623620000OtherAMERIHEALTH/KEYSTONE
018048P26Medicare ID - Type Unspecified
1121763OtherAETNA/USHC
MA64732201OtherCARE FIRST BCBS