Provider Demographics
NPI:1932186954
Name:BARAI, PANNA B (MD)
Entity Type:Individual
Prefix:DR
First Name:PANNA
Middle Name:B
Last Name:BARAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 89TH AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7319
Mailing Address - Country:US
Mailing Address - Phone:219-736-2800
Mailing Address - Fax:219-736-6680
Practice Address - Street 1:200 E 89TH AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7319
Practice Address - Country:US
Practice Address - Phone:219-736-2800
Practice Address - Fax:219-736-6680
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01030108207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100139550AMedicaid
160027238OtherTRAVELERS MEDICARE
IL91115213OtherBLUE CROSS/BLUE SHIELD
000000085040OtherUNICARE
236192OtherHARMONY HEALTH
IN000000085040OtherANTHEM
2118465OtherAETNA
000000085040OtherINDIANA CARPENTERS
100139550AOtherMOLINA
236192OtherWELLCARE
INC25233Medicare UPIN
IN100139550AMedicaid