Individual
KAVITHA BADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1096 S BELSAY RD STE E, BURTON, MI 48509-1948
(810) 762-1020
(810) 762-1042
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2011
(810) 249-4037
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301073879
MI
207Q00000X
Family Medicine Physician
Primary
4301073879
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4428727
—
MI
05
—
4428736
—
MI
05
—
4429751
—
MI
01
—
KB073879
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/11/2006
Last updated
06/26/2025
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