Provider Demographics
NPI:1427642982
Name:BARATI, BABAK (RDN, LDN)
Entity type:Individual
Prefix:MR
First Name:BABAK
Middle Name:
Last Name:BARATI
Suffix:
Gender:M
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 E 9 MILE RD APT 209
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-3027
Mailing Address - Country:US
Mailing Address - Phone:859-420-6016
Mailing Address - Fax:
Practice Address - Street 1:409 E 9 MILE RD APT 209
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-3027
Practice Address - Country:US
Practice Address - Phone:859-420-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered