Physician Compare National (NPI:1508875634)

HEALTHCARE PROVIDER: RAYMOND JOSEPH BADDOUR MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1508875634
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971634304
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100629000840
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BADDOUR
	Individual professional last name
Provider First Name	RAYMOND
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	370 CLINE AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE C8
	Group Practice or individual's line 2 address
City	MANSFIELD
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	449071057
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360118
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OHIOHEALTH MANSFIELD HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360036
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WOOSTER COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360002
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	UNIVERSITY HOSPITALS SAMARITAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	360365
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	AVITA ONTARIO
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	360040
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	KNOX COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1508875634)

HEALTHCARE PROVIDER: RAYMOND JOSEPH BADDOUR MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information