Provider Demographics
NPI:1962504829
Name:BARYUN, ESAM N (MD)
Entity Type:Individual
Prefix:DR
First Name:ESAM
Middle Name:N
Last Name:BARYUN
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:PO BOX 4190
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4190
Mailing Address - Country:US
Mailing Address - Phone:304-399-4405
Mailing Address - Fax:304-399-2526
Practice Address - Street 1:2828 1ST AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1236
Practice Address - Country:US
Practice Address - Phone:304-399-7533
Practice Address - Fax:304-399-7507
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21206207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64068000Medicaid
WV6601940OtherCIGNA
WV613154600OtherBLACK LUNG
WV1842087000Medicaid
OH2420035Medicaid
WV7851511OtherAETNA
WV1062810OtherBRICKSTREET
OH2420035Medicaid
WVP00673256Medicare PIN