Provider Demographics
NPI:1063583706
Name:BARATIAN, MARCUS A (MD)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:A
Last Name:BARATIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR - BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:330-626-9900
Mailing Address - Fax:330-626-8048
Practice Address - Street 1:9480 ROSEMONT DR STE 200
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4569
Practice Address - Country:US
Practice Address - Phone:330-626-9900
Practice Address - Fax:330-626-8048
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076745208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2136156Medicaid
OHBA7263191Medicare ID - Type Unspecified
OH2136156Medicaid