Provider Demographics
NPI:1477880094
Name:BADGER, CHRISTOPHER TIMMONS (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TIMMONS
Last Name:BADGER
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 1:3449 WILKENS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5218
Mailing Address - Country:US
Mailing Address - Phone:410-747-4080
Mailing Address - Fax:410-747-4508
Practice Address - Street 1:3449 WILKENS AVE STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5218
Practice Address - Country:US
Practice Address - Phone:410-747-4080
Practice Address - Fax:410-747-4508
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD72377208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD420574000Medicaid
MDS062-0424OtherCAREFIRST BC/BS - REGIONAL
MD974397-01OtherCAREFIRST BC/BS
MDS062-0424OtherCAREFIRST BC/BS - REGIONAL