Individual
BADI EL OSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1105 NASH SPRINGS CIR, LILBURN, GA 30047-1731
(832) 369-0125
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
076525
GA
207RX0202X
Medical Oncology Physician
Primary
076525
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076525
MEDICAL LICENSE
GA
01
—
M4052
MEDICAL LICENSE
TX
Enumeration date
03/08/2007
Last updated
12/14/2017
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