Provider Demographics
NPI:1720390040
Name:BADARUDEEN, SAMEER (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMEER
Middle Name:
Last Name:BADARUDEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 2ND AVE STE C2
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1791
Mailing Address - Country:US
Mailing Address - Phone:270-780-2750
Mailing Address - Fax:
Practice Address - Street 1:825 2ND AVE STE C2
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1791
Practice Address - Country:US
Practice Address - Phone:270-780-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245444207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery