Basic Information
| Provider Information | |||||||||
| NPI: | 1396150371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BABAA | ||||||||
| FirstName: | NIDAL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 S JEFFERSON ST STE 625 | ||||||||
| Address2: | |||||||||
| City: | ROANOKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240111713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402245516 | ||||||||
| FaxNumber: | 5402245684 | ||||||||
| Practice Location | |||||||||
| Address1: | 1906 BELLEVIEW AVE SE | ||||||||
| Address2: | |||||||||
| City: | ROANOKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240141838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5409817000 | ||||||||
| FaxNumber: | 5408530931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2014 | ||||||||
| LastUpdateDate: | 08/31/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D86138 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD462883 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MT207604 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 60208 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 036.151404 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 2017036838 | MO | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | D86138 | MD | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 25MA09968300 | NJ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 0101263471 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.