1386713600 NPI number — ALI HUSSEIN BAALBAKI MD

Table of content: ALI HUSSEIN BAALBAKI MD (NPI 1386713600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386713600 NPI number — ALI HUSSEIN BAALBAKI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAALBAKI
Provider First Name:
ALI
Provider Middle Name:
HUSSEIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386713600
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4000 COLISEUM DR STE 340
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMPTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23666-5904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-827-2230
Provider Business Mailing Address Fax Number:
757-827-2150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4000 COLISEUM DR STE 340
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMPTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23666-5904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-827-2230
Provider Business Practice Location Address Fax Number:
757-827-2150
Provider Enumeration Date:
11/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  204370 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP2900X , with the licence number: 0101243251 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 202010204 . This is a "MULTIPLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 202010504 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 202010504 . This is a "GREATWEST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 202705274 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41867 . This is a "NHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 495726 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 96062901 . This is a "NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9750720 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: J22499 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1774156 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 202010504 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 203722881 . This is a "GREAT WEST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7895883 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 202010504 . This is a "UNICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9751921 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9760971 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202010504 . This is a "EVERCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 202010504 . This is a "BEECH STREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9606290113 . This is a "CHOICE PLUS NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0100021 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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