Provider Demographics
NPI:1134411341
Name:BARAKAT, MICHEL MAROUN (MD)
Entity type:Individual
Prefix:
First Name:MICHEL
Middle Name:MAROUN
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 1:3837 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5842
Mailing Address - Country:US
Mailing Address - Phone:801-815-2344
Mailing Address - Fax:
Practice Address - Street 1:3837 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-5842
Practice Address - Country:US
Practice Address - Phone:801-815-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WV26006207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program