Provider Demographics
NPI:1013143221
Name:BARAKAT, JAMES J (MILITARY HEALTH/IDC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:BARAKAT
Suffix:
Gender:M
Credentials:MILITARY HEALTH/IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 INTERCOVE RD BLDG 3813
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23521-2932
Mailing Address - Country:US
Mailing Address - Phone:757-492-1798
Mailing Address - Fax:
Practice Address - Street 1:1875 INTERCOVE RD BLDG 3813
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23521-2932
Practice Address - Country:US
Practice Address - Phone:757-492-1798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman