Individual
DR. RAYMOND JOSEPH BADDOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
370 CLINE AVE, STE C5, MANSFIELD, OH 44907-1057
(419) 756-6990
(419) 756-0944
Mailing address
370 CLINE AVE, STE C5, MANSFIELD, OH 44907-1057
(419) 756-6990
(419) 756-0944
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35-078415
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000182209
ANTHEM PROV ID#
OH
05
—
2877801
—
OH
01
—
30022664
RAILROAD MEDICARE ID#
OH
01
—
341934892001
MEDICAL MUTUAL GRP#
OH
01
—
606176800
DEPT OF LABOR ID#
OH
Enumeration date
08/07/2006
Last updated
01/10/2020
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