Organization Name: | ANGELA BADRA DO, PC |
NPI Number: | 1508077140 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANGELA BADRA (OWNER) |
Mailing Address: | 204 W Exchange St Owosso |
State: | MI US |
Postal Code: | 488672818 |
Phone Number: | 9897230046 |
Fax Number: | 9897230052 |
NPI Enumeration Date: | 05/25/2007 |
NPI Last Update Date: | 11/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 5101012489 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |