Provider Demographics
NPI:1386713600
Name:BAALBAKI, ALI HUSSEIN (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:HUSSEIN
Last Name:BAALBAKI
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 1:4000 COLISEUM DR STE 340
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5904
Mailing Address - Country:US
Mailing Address - Phone:757-827-2230
Mailing Address - Fax:757-827-2150
Practice Address - Street 1:4000 COLISEUM DR STE 340
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5904
Practice Address - Country:US
Practice Address - Phone:757-827-2230
Practice Address - Fax:757-827-2150
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204370207LP2900X
VA0101243251207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
202010204OtherMULTIPLANS
202010504OtherUHC
202010504OtherGREATWEST
202705274OtherUHC
41867OtherNHP
495726OtherTUFTS
96062901OtherNETWORK
MA9750720Medicaid
J22499OtherBCBS
1774156OtherCIGNA
202010504OtherPHCS
203722881OtherGREAT WEST
7895883OtherAETNA
202010504OtherUNICARE
MA9751921Medicaid
MA9760971Medicaid
202010504OtherEVERCARE
202010504OtherBEECH STREET
9606290113OtherCHOICE PLUS NETWORK
MA0100021Medicaid
MA100021Medicaid
202705274OtherUHP
202705274OtherGREAT WEST
MA611000600OtherDOL
96062904OtherNETWORK
AA80768OtherHPHC
AA80853OtherHPHC
125217OtherFALLON
1386713600OtherBMC
203722881OtherUHC
NH30207121Medicaid
AA80768OtherHARVARD PILGRIM
2702705274OtherGREAT WEST
96062903OtherNETWORK
AA80846OtherHPHC
495726OtherTUFTS
MA611000600OtherDOL
AA80768OtherHARVARD PILGRIM
AA80768OtherHPHC
203722881OtherUHC