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General NPI Number Information
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NPI Number | 1093899569
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Entity Type | Organization
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Legal Business Name | BADDIGAM FAMILY PSYCHIATRIC ASSOCIATES PLLC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 43211 DALCOMA DR STE. 3
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-6309
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Country | US
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Telephone | 586-263-6812
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Fax | 586-263-6835
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Provider Business Mailing Address
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Address Line | PO BOX 7002
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City | BLOOMFIELD
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State | MI
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Zip | 48302-7002
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Country | US
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Telephone | 586-263-6812
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Fax | 586-263-6835
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. PRAMEELA DEVI BADDIGAM
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Credential | MD
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Telephone | 586-263-6812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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