Healthcare Provider Details

I. General information

NPI: 1427626449
Provider Name (Legal Business Name): AHMED BARAZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5515 PEACH ST
ERIE PA
16509-2603
US

IV. Provider business mailing address

5515 PEACH ST
ERIE PA
16509-2603
US

V. Phone/Fax

Practice location:
  • Phone: 814-868-8294
  • Fax: 814-868-2489
Mailing address:
  • Phone: 814-868-8294
  • Fax: 814-868-2489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.148949
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT222720
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.148949
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: