Provider Demographics
NPI:1629252085
Name:BABAR AND JUSTIN INTERNAL MEDICINE
Entity Type:Organization
Organization Name:BABAR AND JUSTIN INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-541-2300
Mailing Address - Street 1:6107 HAMILTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-2512
Mailing Address - Country:US
Mailing Address - Phone:513-541-2300
Mailing Address - Fax:513-541-3819
Practice Address - Street 1:6107 HAMILTON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-2512
Practice Address - Country:US
Practice Address - Phone:513-541-2300
Practice Address - Fax:513-541-3819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2475665Medicaid
OH2475665Medicaid