MEDICARE: DR. M-AMIN BADAWI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301057325	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063430981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. M-AMIN BADAWI M.D.

Provider Business Mailing Address
First Line	:	5570 LAHSER RD
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-2008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5770 HIGHLAND RD
Second Line	:	SUITE 1
City	:	WATERFORD
State	:	MI
Zip	:	48327-1877
Country	:	US
Telephone Number	:	248-618-0011
Fax Number	:	248-618-0913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	12/05/2012

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