Individual
DR. CHRISTIAN J BADDOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1456 PARK AVE W STE M, MANSFIELD, OH 44906-2700
(419) 529-1471
(419) 529-1473
Mailing address
1456 PARK AVE W STE M, MANSFIELD, OH 44906-2700
(419) 529-1471
(419) 529-1473
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34006375
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000162607
ANTHEM
OH
05
—
2015036
—
OH
Enumeration date
12/21/2006
Last updated
07/09/2007
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