Fadi Baladi, MD

Individual provider Active NPI Internal Medicine Physician · Phillipston, MA

NPI 1801877873 · NPPES record last updated Mar 24, 2010

Key facts

NPI
1801877873
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
80541 (MA)
Practice address
20 State Road
Phillipston, MA 01331
Phone
(978) 249-8134
Fax
(978) 249-8137
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
80541MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Internal Medicine Past Accepting new patients
Physicians of North Worcester County Internal Medicine Past
since May 17, 2005
Accepting new patients
Fadi Baladi MD PC Internal Medicine Past
since Oct 21, 2008
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 80541 MA Yes

Addresses

Primary practice location

20 State Road
Phillipston, MA 01331

Mailing address

20 State Road
Phillipston, MA 01331
Phone (978) 249-8134

Other identifiers

IdentifierTypeStateIssuer
3141403MedicaidMA
23815OtherMAFALLON COMMUNITY HEALTH
8954334OtherMACIGNA
9743570MedicaidMA
J16114OtherMABLUE CROSS BLUE SHIELD
TUFTS HEALTH PLANOtherMA080541

Other providers in Phillipston, MA

All providers in Phillipston, MA · Internal Medicine Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.