Healthcare Provider Details

I. General information

NPI: 1154342145
Provider Name (Legal Business Name): NADER TALAT BADDAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NADER TALAT BADDAR M.D.

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 ABERDEEN RD SUITE A
HAMPTON VA
23661-1332
US

IV. Provider business mailing address

704 THIMBLE SHOALS BLVD SUITE 200
NEWPORT NEWS VA
23606-4544
US

V. Phone/Fax

Practice location:
  • Phone: 757-825-1100
  • Fax: 757-838-2034
Mailing address:
  • Phone: 757-240-5580
  • Fax: 757-240-5578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number0101037720
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101037720
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number0101037720
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: