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Organization

YMB SURGERY P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YAQUB M. BARAKI M.D. (SOLE MANAGER)
(818) 970-4497
Entity
Organization

Contact information

Practice address
44084 RIVERSIDE PKWY, SUITE 230, LANSDOWNE, VA 20176-5102
(703) 687-3158
(703) 687-3166
Mailing address
10845 PHILADELPHIA RD, WHITE MARSH, MD 21162-1717
(410) 335-0008
(410) 335-3113

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
198107
MEDICARE
MD
01
227971
MEDICARE
DC
01
510466100
MEDICAL ASSISTANCE
MD
01
CB4QY
CAREFIRST
MD
01
E050
MEDICARE
VA
01
X739
CAREFIRST
DC
Enumeration date
07/26/2010
Last updated
12/18/2014
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