Individual
DR. ANDREW PAUL BARAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6130 PRESTLEY MILL RD STE C, DOUGLASVILLE, GA 30134-2288
(678) 838-3903
(678) 838-7454
Mailing address
2323 E PARIS AVE SE, STE 102, GRAND RAPIDS, MI 49546-2414
(616) 285-3733
(616) 285-5960
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
67354
GA
207Y00000X
Otolaryngology Physician
AB007458
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003126984D
—
GA
01
—
0454110994
BCBS
MI
05
—
2121408
—
MI
Enumeration date
05/03/2006
Last updated
04/20/2022
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