Healthcare Provider Details

I. General information

NPI: 1225073729
Provider Name (Legal Business Name): MARAT BAKMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US

IV. Provider business mailing address

DEPT AT 952288
ATLANTA GA
31192-0001
US

V. Phone/Fax

Practice location:
  • Phone: 561-548-3727
  • Fax: 561-548-1238
Mailing address:
  • Phone: 305-503-5610
  • Fax: 305-503-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME95564
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberME95564
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: