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General NPI Number Information
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NPI Number | 1134390735
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL BARAK D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2008
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 6517 TIPPECANOE RD BUILDING D SUITE 100
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City | CANFIELD
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State | OH
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Zip | 44406-8180
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Country | US
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Telephone | 330-286-0462
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Fax |
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Provider Business Mailing Address
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Address Line | 6517 TIPPECANOE RD BUILDING D SUITE 100
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City | CANFIELD
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State | OH
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Zip | 44406-8180
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Country | US
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Telephone | 330-286-0462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36.003489
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License Number State | OH
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