Provider Demographics
NPI:1497968903
Name:AL NEMR, BADIE (MD)
Entity Type:Individual
Prefix:
First Name:BADIE
Middle Name:
Last Name:AL NEMR
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 1:128 WERTZ AVE NW
Mailing Address - Street 2:SUITE C
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708
Mailing Address - Country:US
Mailing Address - Phone:330-454-7722
Mailing Address - Fax:330-454-7834
Practice Address - Street 1:128 WERTZ AVE NW
Practice Address - Street 2:SUITE C
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708
Practice Address - Country:US
Practice Address - Phone:330-454-7722
Practice Address - Fax:330-454-7834
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.089345207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2762694Medicaid
OH2762694Medicaid