Healthcare Provider Details

I. General information

NPI: 1396320263
Provider Name (Legal Business Name): BADIE BATTI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11275 ALLEN RD
SOUTHGATE MI
48195-3380
US

IV. Provider business mailing address

11275 ALLEN RD
SOUTHGATE MI
48195-3380
US

V. Phone/Fax

Practice location:
  • Phone: 313-383-7071
  • Fax: 313-383-7194
Mailing address:
  • Phone: 313-383-7071
  • Fax: 313-383-7194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01094357A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01094357A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: