Provider Demographics
NPI:1346351756
Name:BADRO, NABIL I (MD)
Entity Type:Individual
Prefix:
First Name:NABIL
Middle Name:I
Last Name:BADRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 ELVATON RD SUITE 3
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061
Mailing Address - Country:US
Mailing Address - Phone:410-590-8999
Mailing Address - Fax:410-768-3260
Practice Address - Street 1:7801 ELVATON RD SUITE 3
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:US
Practice Address - Phone:410-590-8999
Practice Address - Fax:410-768-3260
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26839208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE012OtherBLUECHOICE ID #
MD1304NIOtherCAREFIRST, MARYLAND #
MD020004571OtherRAILROAD MEDICARE #
MD301071600Medicaid
MD301071600Medicaid
MDE012OtherBLUECHOICE ID #