Provider Demographics
NPI:1699752071
Name:BARADARAN, PARINAZ (MD)
Entity type:Individual
Prefix:DR
First Name:PARINAZ
Middle Name:
Last Name:BARADARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4704
Mailing Address - Country:US
Mailing Address - Phone:302-468-4500
Mailing Address - Fax:302-468-4831
Practice Address - Street 1:1016 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-4704
Practice Address - Country:US
Practice Address - Phone:302-468-4500
Practice Address - Fax:302-468-4831
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401422207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900715Medicaid
I21348Medicare UPIN
NC5900715Medicaid