Provider Demographics
NPI:1588876056
Name:KADO, RUBA BARAKAT (MD)
Entity type:Individual
Prefix:
First Name:RUBA
Middle Name:BARAKAT
Last Name:KADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUBA
Other - Middle Name:
Other - Last Name:BARAKAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2550 S TELEGRAPH RD
Mailing Address - Street 2:STE 104
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0951
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:2550 S TELEGRAPH RD STE 104
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0951
Practice Address - Country:US
Practice Address - Phone:319-530-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100096207R00000X, 207RR0500X
FL107214207R00000X
FLME107214208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002844700Medicaid
FL9400727OtherBCBS FL
FLP00897388OtherRR MEDICARE
FL9400727OtherBCBS FL