# ANGELA BADRA DO, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508077140
- **Authorized official:** ANGELA BADRA DO (OWNER)
- **Authorized official phone:** (989) 723-0046

## Contact information

- **Practice address:** 204 W EXCHANGE ST, OWOSSO, MI 48867-2818
- **Practice address phone:** (989) 723-0046
- **Practice address fax:** (989) 723-0052
- **Mailing address:** 204 W EXCHANGE ST, OWOSSO, MI 48867-2818
- **Mailing address phone:** (989) 723-0046
- **Mailing address fax:** (989) 723-0052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 5101012489 | MI | Yes |

## Other

- **Enumeration date:** 05/25/2007
- **Last updated:** 11/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | P00209171 | RAILROAD MEDICARE | MI |