Provider Demographics
NPI:1023305885
Name:LAKSHMI P BADDELA, M.D.,P.C.
Entity type:Organization
Organization Name:LAKSHMI P BADDELA, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKSHMI
Authorized Official - Middle Name:PRASINA
Authorized Official - Last Name:BADDELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-371-6999
Mailing Address - Street 1:2635 SMALLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1532
Mailing Address - Country:US
Mailing Address - Phone:443-371-6999
Mailing Address - Fax:443-371-6998
Practice Address - Street 1:2635 SMALLWOOD DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1532
Practice Address - Country:US
Practice Address - Phone:443-371-6999
Practice Address - Fax:443-371-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-30
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047873305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM281OtherFEDERAL BLUE CROSS, BLUE CHOICE, ETC
MD942649097OtherUHC
MDIP166039OtherAETNA USHA
MD14VPOtherBCBS
MD14VPOtherBCBS
MD570RMedicare PIN