Provider Demographics
NPI:1053332064
Name:EMED INC
Entity Type:Organization
Organization Name:EMED INC
Other - Org Name:I&O MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:N.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BADDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-825-1100
Mailing Address - Street 1:704 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4544
Mailing Address - Country:US
Mailing Address - Phone:757-240-5580
Mailing Address - Fax:757-240-5578
Practice Address - Street 1:704 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4544
Practice Address - Country:US
Practice Address - Phone:757-240-5580
Practice Address - Fax:757-240-5578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA28490OtherANTHEM
VA28490OtherANTHEM