Organization
WALID J. BADDOURA M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALID J BADDOURA M.D. (OWNER)
(973) 777-7733
Entity
Organization
Contact information
Practice address
716 BROAD ST, CLIFTON, NJ 07013-1645
(973) 777-7733
(973) 777-0669
Mailing address
716 BROAD ST, CLIFTON, NJ 07013-1645
(973) 777-7733
(973) 777-0669
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MA33827
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3075001
—
NJ
Enumeration date
09/29/2006
Last updated
12/12/2011
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