Provider Demographics
NPI:1093899569
Name:BADDIGAM FAMILY PSYCHIATRIC ASSOCIATES PLLC
Entity Type:Organization
Organization Name:BADDIGAM FAMILY PSYCHIATRIC ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAMEELA
Authorized Official - Middle Name:DEVI
Authorized Official - Last Name:BADDIGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-263-6812
Mailing Address - Street 1:PO BOX 7002
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48302-7002
Mailing Address - Country:US
Mailing Address - Phone:586-263-6812
Mailing Address - Fax:586-263-6835
Practice Address - Street 1:43211 DALCOMA DR
Practice Address - Street 2:STE. 3
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6309
Practice Address - Country:US
Practice Address - Phone:586-263-6812
Practice Address - Fax:586-263-6835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1082559OtherAETNA
PB055388OtherLIC
MIVM053562OtherLIC
MI260E021040OtherBCBSM GRP
0459615OtherVALUE OPTIONS
MI1265467682OtherNPI
MI2605017381OtherBCBS
MI476905610Medicaid
5840532OtherVALUE OPTIONS
F63502OtherHAP
MI476904710Medicaid
819269000OtherMAGELLAN
MIBB053679OtherLIC
MI1033313069Medicaid
138868OtherCARE CHOICES
2204444OtherCIGNA
MI2605017531OtherBCS
140176OtherCARE CHOICES
MI680E020960OtherBCBSM PHD GRP
5840532OtherVALUE OPTIONS
819269000OtherMAGELLAN
MI680E020960OtherBCBSM PHD GRP
MIVM053562OtherLIC
MI1265467682OtherNPI
F40891Medicare UPIN