Provider Demographics
NPI:1639811334
Name:BADR, BISMA (MD)
Entity Type:Individual
Prefix:DR
First Name:BISMA
Middle Name:
Last Name:BADR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:BISMAH
Other - Middle Name:
Other - Last Name:BADR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1980
Mailing Address - Street 2:NORFOLK, VA 23501-1980
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501
Mailing Address - Country:US
Mailing Address - Phone:757-446-5600
Mailing Address - Fax:
Practice Address - Street 1:601 CHILDREN'S LANE EASTERN VIRGINIA MEDICAL SCHOOL
Practice Address - Street 2:NORFOLK, VA 23507-9982
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507
Practice Address - Country:US
Practice Address - Phone:757-668-7249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2023-01-31
Deactivation Date:2023-01-03
Deactivation Code:
Reactivation Date:2023-01-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program