Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 35.095587 | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 35.095587 | OH |
N | 208200000X | Surgeon | 35-095587 | OH |
N | 208600000X | Surgeon | 35-095587 | OH |
N | 208200000X | Surgeon | 804 | NM |
N | 208600000X | Surgeon | 804 | NM |
NPI | 1265503700 |
---|---|
Provider Name | Nur Badshah |
First Address | Columbus, OH 43224 |
Second Address | Columbus, OH 43224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3080517 | (05) | OH |
C67283 | (02) |