Provider Demographics
NPI:1407814411
Name:BADKE, FREDERICK R (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:R
Last Name:BADKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6140 W. CURTISIAN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8881
Mailing Address - Country:US
Mailing Address - Phone:208-322-1680
Mailing Address - Fax:208-322-1695
Practice Address - Street 1:6140 CURTISIAN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8880
Practice Address - Country:US
Practice Address - Phone:208-322-1680
Practice Address - Fax:208-322-1695
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM4677207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease