Walid J. Baddoura M.D.,P.a.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MA33827 Issued in NJ

Legal business name

WALID J. BADDOURA M.D.,P.A.

Practice address

716 Broad St
Clifton, NJ 07013-1645

Phone

(973) 777-7733

Fax

(973) 777-0669

NPI assigned

Sep 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Walid J Baddoura, M.D.

Title

Owner

Phone

(973) 777-7733

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1467544015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645",
            "telephone_number": "973-777-7733",
            "fax_number": "973-777-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131645",
            "telephone_number": "973-777-7733",
            "fax_number": "973-777-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALID J. BADDOURA M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "BADDOURA",
        "authorized_official_first_name": "WALID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-777-7733",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA33827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3075001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Gerald E Wall, RP
• Sara Walles, LCSW
• Wallington Footcare Center, Inc.
• Justin Uriah Walters, MD
• Daniel Wanio

• Gastroenterology Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.