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Individual

DR. BASIVI REDDY BADDIGAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
43211 DALCOMA DR, STE. 3, CLINTON TWP, MI 48038-6309
(586) 263-6812
(586) 263-6835
Mailing address
PO BOX 7002, BLOOMFIELD, MI 48302-7002
(586) 466-9718
(586) 466-9961

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301053679
MI
2084P0804X
Child & Adolescent Psychiatry Physician
4301053679
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
045965
VALUEOPTIONS
MI
01
0501753
BCBSM
MI
01
1082559
AETNA
01
138868
CARECHOICES
MI
01
1536832
UBH
01
2605021781
BCBSM
MI
05
4769047-10
MI
01
819269000
MAGELLAN
MI
01
F46966
HAP
MI
Enumeration date
08/02/2005
Last updated
02/10/2021
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