Provider Demographics
NPI:1093070971
Name:BADIE, SARA J
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:J
Last Name:BADIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3395 BOULDERCREST RD
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-1639
Mailing Address - Country:US
Mailing Address - Phone:404-333-5917
Mailing Address - Fax:404-241-3282
Practice Address - Street 1:3395 BOULDERCREST RD
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-1639
Practice Address - Country:US
Practice Address - Phone:404-333-5917
Practice Address - Fax:404-241-3282
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist