Provider Demographics
NPI:1952306730
Name:BARAKAT, KUSAY (MD)
Entity Type:Individual
Prefix:
First Name:KUSAY
Middle Name:
Last Name:BARAKAT
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:CARDIOLOGY CENTER
Mailing Address - Street 2:310 WEST NINTH STREET
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4546
Mailing Address - Country:US
Mailing Address - Phone:301-694-5900
Mailing Address - Fax:301-694-0569
Practice Address - Street 1:CARDIOLOGY CENTER
Practice Address - Street 2:310 WEST NINTH STREET
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4546
Practice Address - Country:US
Practice Address - Phone:301-694-5900
Practice Address - Fax:301-694-0569
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD21648207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD776551700Medicaid
MD015BMedicare ID - Type Unspecified
MD776551700Medicaid