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General NPI Number Information
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NPI Number | 1154342160
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Entity Type | Organization
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Legal Business Name | IMED, INC.
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 838 OLD GEORGE WASHINGTON HWY N SUITE A
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City | CHESAPEAKE
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State | VA
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Zip | 23323-2209
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Country | US
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Telephone | 757-487-9600
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Fax | 757-487-6090
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Provider Business Mailing Address
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Address Line | 704 THIMBLE SHOALS BLVD SUITE 200
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4544
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Country | US
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Telephone | 757-240-5580
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Fax | 757-240-5578
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. N. MICHAEL BADDAR
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Credential | M.D.
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Telephone | 757-825-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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