MEDICARE: THOMAS BARWACZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	126370	OH

General Provider Information

NPI Number	:	1316213077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS BARWACZ MD

Provider Business Mailing Address
First Line	:	14200 RIDGE RD
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4972
Country	:	US
Telephone Number	:	440-582-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	14200 RIDGE RD
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4972
Country	:	US
Telephone Number	:	440-582-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	12/07/2020

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