MEDICARE: DR. AKHIL BARANWAL 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	207RH0003X	Hematology & Oncology Physician	051294	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013916576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKHIL BARANWAL MD

Provider Business Mailing Address
First Line	:	1105 LEE AVE
Second Line	:
City	:	DOUGLAS
State	:	GA
Zip	:	31533-3409
Country	:	US
Telephone Number	:	912-393-5051
Fax Number	:	954-301-6333

Provider Business Practice Location Address
First Line	:	1105 LEE AVE
Second Line	:
City	:	DOUGLAS
State	:	GA
Zip	:	31533-3409
Country	:	US
Telephone Number	:	912-393-5051
Fax Number	:	954-301-6333

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/26/2007

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