Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 19963 | AZ |
N | 207RS0012X | Sleep Medicine | 19963 | AZ |
NPI | 1104879436 |
---|---|
Provider Name | Dr. David Michael Baratz |
First Address | Mesa, AZ 85206-1346 |
Second Address | Phoenix, AZ 85032-2158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 09/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
052093 | (05) | AZ |
19963 | AZ MD LIC (01) | AZ |
E53378 | (02) | |
Z29WCFJN09 | MEDICARE (01) | AZ |