Provider Demographics
NPI:1811966708
Name:BADDAR, ADRIAN TALAT (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:TALAT
Last Name:BADDAR
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 1:730 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4562
Mailing Address - Country:US
Mailing Address - Phone:757-873-1554
Mailing Address - Fax:757-873-3239
Practice Address - Street 1:730 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4562
Practice Address - Country:US
Practice Address - Phone:757-873-1554
Practice Address - Fax:757-873-3239
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058252207XS0114X, 207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1811966708OtherPHCS
VA1811966708OtherHUMANA
VA1811966708OtherUNITED HEALTHCARE
VA1811966708OtherVIRGINIA HEALTH NETWORK
VA426750OtherSOUTHERN HEALTH SERVICES
VA010063990Medicaid
VA138355OtherBLUE CROSS BLUE SHIELD
VA1811966708OtherMULTIPLAN
VA7910511OtherAETNA
VA1811966708OtherMAMSI
VA9302762003OtherCIGNA
VA1811966708OtherTRICARE
VA2128977OtherMAMSI
VA76720OtherOPTIMA
VA76720OtherOPTIMA
004430H04Medicare ID - Type Unspecified
VA1811966708OtherMAMSI