Provider Demographics
NPI:1861681405
Name:BADWAN, AMJAD MINWER (OD)
Entity Type:Individual
Prefix:DR
First Name:AMJAD
Middle Name:MINWER
Last Name:BADWAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 PARKWAY OFFICE CT STE 112
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7438
Mailing Address - Country:US
Mailing Address - Phone:919-859-0777
Mailing Address - Fax:919-415-0443
Practice Address - Street 1:100 PARKWAY OFFICE CT STE 112
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7438
Practice Address - Country:US
Practice Address - Phone:919-859-0777
Practice Address - Fax:919-415-0443
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2105152W00000X
VA0618001687152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist