Individual
DR. IAN D/ BARONOFSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-102797
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-102797-1
—
IL
05
—
316286903
—
TX
Enumeration date
10/11/2005
Last updated
01/12/2015
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