1104900083

Everything you always wanted to know about DR. BARAK STEPHANIE M.D. 1 HART-GOULEAU STEPHANIE M.D but were afraid to ask.

DR. BARAK STEPHANIE M.D. 1 HART-GOULEAU STEPHANIE M.D

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Provider Prefix Provider Last Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Last Name Provider Other First Name Provider Other Credential
DR. BARAK STEPHANIE M.D. 1 HART-GOULEAU STEPHANIE M.D
Gender:
Female
Enumeration date:
2006-10-25
Last update date:
2014-03-12
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
168735 Medicare UPIN none MP

Taxonomies

Taxonomy State License Number Primary?
207Q00000X Family Medicine MP 0404
207ZP0104X Chemical Pathology DC MD040068
Pain Medicine Pain Medicine DC MD040068

Phone Numbers

Type Number
Mailing Address Telephone Number 2408885935
Practice Location Address Telephone Number 2408885935

Addresses

Type Address City State Postal Country
Mailing Address 4242 MATHEWSON DR NW WASHINGTON DC 20011 DC
Practice Location Address 4242 MATHEWSON DR NW WASHINGTON DC 20011 DC