Provider Demographics
NPI:1922425453
Name:BADAWY, ISLAM ADEL (DO)
Entity Type:Individual
Prefix:DR
First Name:ISLAM
Middle Name:ADEL
Last Name:BADAWY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:ISLAM
Other - Middle Name:ADEL
Other - Last Name:BAGHDADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 S LAKE PARK AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6791
Mailing Address - Country:US
Mailing Address - Phone:219-942-6166
Mailing Address - Fax:219-942-4106
Practice Address - Street 1:1400 S LAKE PARK AVE STE 400
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6791
Practice Address - Country:US
Practice Address - Phone:219-942-6166
Practice Address - Fax:219-942-4106
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005065A208M00000X, 207RI0011X
IN20225065A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology