MEDICARE: DR. BADI ALTAWIL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35.072864	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841281797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BADI ALTAWIL MD

Provider Business Mailing Address
First Line	:	4439 MAHONING AVE NW STE A
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-1975
Country	:	US
Telephone Number	:	330-847-6527
Fax Number	:	330-847-6572

Provider Business Practice Location Address
First Line	:	4439 MAHONING AVE NW STE A
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44483-1975
Country	:	US
Telephone Number	:	330-847-6527
Fax Number	:	330-847-6572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	03/03/2026

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