Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 073426 | GA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 073426 | GA |
NPI | 1578880100 |
---|---|
Provider Name | Harry Michael Baddour JR. |
First Address | Atlanta, GA 30308-2234 |
Second Address | Atlanta, GA 30308-2234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2010 |
Last Update Date | 04/05/2015 |