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NPI Code Detail

MEDICARE: DR. MATILDA OLAJUMOKE BARAKA M.D., M.P.H.

MEDICARE: DR. MATILDA OLAJUMOKE BARAKA M.D., M.P.H.
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
12080P0208XPediatric Infectious Diseases Physician74053AZ
2207RI0200XInfectious Disease Physician74053AZ

Other Identifiers

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

General Provider Information

NPI Number : 1952765679
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATILDA OLAJUMOKE BARAKA M.D., M.P.H.
Provider Business Mailing Address
First Line : 2108 E THOMAS RD STE 130
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-0008
Country : US
Telephone Number : 602-933-3124
Fax Number :
Provider Business Practice Location Address
First Line : 1919 E THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-7710
Country : US
Telephone Number : 602-933-1060
Fax Number : 602-933-8982
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2016
Last Update Date : 02/04/2026

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