Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 0101037720 | VA |
N | 208D00000X | General Practice Physician | 0101037720 | VA |
NPI | 1154342145 |
---|---|
Provider Name | Dr. Nader Talat Baddar |
First Address | Newport News, VA 23606-4544 |
Second Address | Hampton, VA 23661-1332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 29/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005641144 | (05) | VA |
174879 | ANTHEM (01) | VA |
208497 | ANTHEM (01) | VA |
268197 | ANTHEM (01) | VA |
320923 | ANTHEM (01) | VA |
60054NOCD | AETNA (01) | VA |
B-59847 | (02) | VA |