MEDICARE: DR. BARRY L BAKST D.O.

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	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	C20002764	DE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
11	250008397	OTHER	DE	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2445310	OTHER	DE	CIGNA
2	510329923	OTHER	DE	UNITED HEALTH CARE
3	510329923	OTHER	DE	TRICARE
4	P3278310	OTHER	DE	OXFORD HEALTH PLAN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	2008059	OTHER	DE	AETNA-HMO
7	4295831	OTHER	DE	AETNA-PPO
8	510329923	OTHER	DE	DEVON NETWORK
9	293733	OTHER	DE	MAMSI
10	0000102003	OTHER	DE	DE PHYSICIANS CARE
12	44003	OTHER	CT	COVENTRY
13	0091456000	OTHER	DE	AMERIHEALTH-HMO
14	193245	OTHER	DE	AMERIHEALTH-PPO

General Provider Information

NPI Number	:	1235154741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY L BAKST D.O.

Provider Business Mailing Address
First Line	:	2006 FOULK RD
Second Line	:	SUITE B
City	:	WILMINGTON
State	:	DE
Zip	:	19810-3644
Country	:	US
Telephone Number	:	302-529-8783
Fax Number	:	302-529-7470

Provider Business Practice Location Address
First Line	:	2006 FOULK RD
Second Line	:	SUITE B
City	:	WILMINGTON
State	:	DE
Zip	:	19810-3644
Country	:	US
Telephone Number	:	302-529-8783
Fax Number	:	302-529-7470

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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