Provider Demographics
NPI:1134146111
Name:BADY, PEJMAN (DO)
Entity Type:Individual
Prefix:DR
First Name:PEJMAN
Middle Name:
Last Name:BADY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6255
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89041-6255
Mailing Address - Country:US
Mailing Address - Phone:702-984-6587
Mailing Address - Fax:702-463-2894
Practice Address - Street 1:5741 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5622
Practice Address - Country:US
Practice Address - Phone:702-984-6587
Practice Address - Fax:866-496-8313
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV828204C00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00870033OtherRAILROAD MEDICARE
NV1134146111Medicaid
NVDR672YMedicare PIN
NVP00870033OtherRAILROAD MEDICARE