Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 290489 | MA |
N | 208600000X | Surgeon | 290489 | MA |
N | 208200000X | Surgeon | MD446869 | PA |
N | 208600000X | Surgeon | MD446869 | PA |
Y | 2086S0102X | Surgical Critical Care | 290489 | MA |
N | 2086S0102X | Surgical Critical Care | MD446869 | PA |
NPI | 1114127420 |
---|---|
Provider Name | Jehangir Badar |
First Address | North Andover, MA 01845 |
Second Address | Lowell, MA 01854-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2007 |
Last Update Date | 03/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102758421 | (05) | PA |