Individual
DIMITRY Y BARANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, 4 DULLES, PHILADELPHIA, PA 19104-4206
(215) 349-8310
(215) 662-2739
Mailing address
3400 SPRUCE STREET, 4 DULLES, PHILADELPHIA, PA 19104-4206
(215) 349-8310
(215) 662-2739
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD064726L
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD064726L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017992490001
—
PA
Enumeration date
06/09/2006
Last updated
03/28/2012
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