Healthcare Provider Details

I. General information

NPI: 1124132691
Provider Name (Legal Business Name): URWA BARAKAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 EASTLAND AVE SE STE 301
WARREN OH
44484-4501
US

IV. Provider business mailing address

627 EASTLAND AVE SE STE 301
WARREN OH
44484-4501
US

V. Phone/Fax

Practice location:
  • Phone: 330-392-3099
  • Fax: 330-395-1721
Mailing address:
  • Phone: 330-392-3099
  • Fax: 330-395-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.2072288
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.2072288
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35.2072288
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: