Provider Demographics
NPI:1790569093
Name:BARRON, DARIUS R
Entity Type:Individual
Prefix:
First Name:DARIUS
Middle Name:R
Last Name:BARRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18012 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1273
Mailing Address - Country:US
Mailing Address - Phone:216-327-8635
Mailing Address - Fax:
Practice Address - Street 1:18012 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-1273
Practice Address - Country:US
Practice Address - Phone:216-327-8635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide