Provider Demographics
NPI:1821133323
Name:BADARINATH, SUHAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SUHAS
Middle Name:
Last Name:BADARINATH
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 1:1100 ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-1003
Mailing Address - Country:US
Mailing Address - Phone:732-849-0077
Mailing Address - Fax:732-849-0015
Practice Address - Street 1:2702 BACK ACRE CIR STE 290B
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-7769
Practice Address - Country:US
Practice Address - Phone:301-703-8767
Practice Address - Fax:301-703-8766
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME155546208VP0000X
MDD0078317208VP0000X
MDP20519208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME155546OtherSTATE LICENSE
TX1942898801Medicaid
8W5187OtherBLUE CROSS BLUE SHIELD OF TX
TX8K8012Medicare PIN