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Individual

LAKSHMI PRASUNA BADDELA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2635 SMALLWOOD DR, ABINGDON, MD 21009-1532
(410) 569-1399
Mailing address
2635 SMALLWOOD DR, ABINGDON, MD 21009-1532
(410) 569-1399

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0047873
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IBO3
BLUE CROSS/BLUE SHIELD
MD
01
M281
FEDERAL/BLUE CHOICE
MD
Enumeration date
07/07/2006
Last updated
07/08/2007
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