Provider Demographics
NPI:1245220375
Name:BADREDDINE, HANA M (MD)
Entity Type:Individual
Prefix:
First Name:HANA
Middle Name:M
Last Name:BADREDDINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1204
Mailing Address - Country:US
Mailing Address - Phone:513-524-5549
Mailing Address - Fax:
Practice Address - Street 1:110 N POPLAR ST
Practice Address - Street 2:CLINIC 3
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1204
Practice Address - Country:US
Practice Address - Phone:513-524-5549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074843207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2197555Medicaid
IN200366730Medicaid
KY64041809Medicaid
OH0898052Medicare PIN
OH0898054Medicare PIN
OH2197555Medicaid
F91916Medicare UPIN