Provider Demographics
NPI:1336183268
Name:BARAN, ALP S (MD)
Entity Type:Individual
Prefix:DR
First Name:ALP
Middle Name:S
Last Name:BARAN
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 1:3621 S STATE ST
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:4250 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-2700
Practice Address - Country:US
Practice Address - Phone:734-764-6443
Practice Address - Fax:734-763-5580
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS153862084P0800X, 2084S0012X
MI43010642792084P0800X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS260038809OtherRAILROAD MEDICARE
MS00118727Medicaid
MS00118727Medicaid
MS260000372Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MS512I260021Medicare PIN
MS260038809OtherRAILROAD MEDICARE