Provider Demographics
NPI:1730316928
Name:BAHADOR, FARSHAD MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:FARSHAD
Middle Name:MICHAEL
Last Name:BAHADOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MOHAMMAD
Other - Middle Name:
Other - Last Name:BAHADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100202692085R0202X
ALMD.352612085R0202X
CODR.00553172085R0202X
CAA1294142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL190163Medicaid
AL212770Medicaid
AL243189Medicaid
AL245460Medicaid
AL190082Medicaid
AL190164Medicaid
AL242944Medicaid
AL190081Medicaid
AL190311Medicaid
13820298OtherCAQH
CA1730316928Medicaid
AL190410Medicaid
AL239951Medicaid
AL242457Medicaid
AL243071Medicaid
AL244239Medicaid