Provider Demographics
NPI:1801848783
Name:BADMAN, BRIAN L (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:L
Last Name:BADMAN
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 1:3600 W BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5407
Mailing Address - Country:US
Mailing Address - Phone:800-622-6575
Mailing Address - Fax:765-284-4266
Practice Address - Street 1:14300 E 138TH STE B
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-0051
Practice Address - Country:US
Practice Address - Phone:800-622-6575
Practice Address - Fax:765-608-3687
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061086A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200807590Medicaid
INP00814842OtherRAILROAD MEDICARE
INP00834672OtherRAILROAD MEDICARE
INP00814842OtherRAILROAD MEDICARE
IN200807590Medicaid
IN192770D6Medicare PIN
IN194850002Medicare PIN
IN354590HMedicare PIN
INM400049652Medicare PIN
IN859910G7Medicare PIN