Provider Demographics
NPI:1922105675
Name:BARANEK, ROBERT ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALLEN
Last Name:BARANEK
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 1:75 ARCH ST
Mailing Address - Street 2:SUITE 412
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1429
Mailing Address - Country:US
Mailing Address - Phone:330-762-0366
Mailing Address - Fax:330-996-4066
Practice Address - Street 1:75 ARCH ST
Practice Address - Street 2:SUITE 412
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1429
Practice Address - Country:US
Practice Address - Phone:330-762-0366
Practice Address - Fax:330-996-4066
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36041208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0957782Medicare ID - Type Unspecified
OHA75738Medicare UPIN
OHBA0427771Medicare ID - Type Unspecified