Provider Demographics
NPI:1710907324
Name:BADE, ASIMA JABEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ASIMA
Middle Name:JABEEN
Last Name:BADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 CHRISTENSEN CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1337
Mailing Address - Country:US
Mailing Address - Phone:703-869-0222
Mailing Address - Fax:
Practice Address - Street 1:6655 SYKESVILLE RD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784
Practice Address - Country:US
Practice Address - Phone:410-970-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060208207Q00000X
VA0101241061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1710907324Medicaid
VA020779V94Medicare PIN
DC163791ZBDDMedicare PIN
VA021755I11Medicare PIN