Basic Information
Provider Information
NPI: 1013975259
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARAKAT
FirstName: SUHEIL
MiddleName: I
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 915 13TH AVE N
Address2:  
City: CLINTON
State: IA
PostalCode: 527325067
CountryCode: US
TelephoneNumber: 5632432511
FaxNumber: 5632430817
Practice Location
Address1: 915 13TH AVE N
Address2:  
City: CLINTON
State: IA
PostalCode: 527325067
CountryCode: US
TelephoneNumber: 5632432511
FaxNumber: 5632430817
Other Information
ProviderEnumerationDate: 05/03/2006
LastUpdateDate: 03/15/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X27401IAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
IA013101 JOHN DEERE HEALTHOTHER
026487905IA MEDICAID
01839801 HEALTH ALLIANCEOTHER
1897101 MIDLANDS CHOICEOTHER
2030401 WELLMARK BC/BSOTHER
2717601 IOWA HEALTH SOLUTIONSOTHER


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