Provider Demographics
NPI:1518964063
Name:BADSHA, HUMEIRA
Entity Type:Individual
Prefix:
First Name:HUMEIRA
Middle Name:
Last Name:BADSHA
Suffix:
Gender:F
Credentials:
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 9120
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02027-9120
Mailing Address - Country:US
Mailing Address - Phone:781-329-1400
Mailing Address - Fax:781-278-5667
Practice Address - Street 1:1 LYONS ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5599
Practice Address - Country:US
Practice Address - Phone:781-329-1400
Practice Address - Fax:781-278-5667
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD216730207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
32-00318OtherUNITED HEALTHCARE HMO PPO
J26191OtherBS- BLUE CARE ELECT
HARVARD/PILGRIMOther25859
J26191OtherHMO BLUE/BLUE CHOICE
0030078OtherNEIGHBORHOOD HEALTH PLAN
25859OtherFIRST SENIORITY
216730OtherTUFTS COMMONWEALTH PPO
216730OtherTUFTS TOTAL HEALTH PLAN
25859OtherHARVARD PILGRIM POS
25859OtherHARVARD PILGRIM PPO
4445196OtherCIGNA HEALTH CARE
4445196OtherHELATHSOURCE MASSACHUSETT
47634OtherCHILDREN'S MEDICAL SECURI
216730OtherTUFTS BENEFIT ADMIN.
J26191OtherBLUE SHIELD-INDEMNITY
2018721OtherMASS HEALTH (DIV OF MED)
216730OtherTUFTS
32-00318OtherUNITED HEALTHCARE HMO PPO
H90700Medicare UPIN