Provider Demographics
NPI:1750723268
Name:BADWAL, JASDEEP S (MD)
Entity type:Individual
Prefix:DR
First Name:JASDEEP
Middle Name:S
Last Name:BADWAL
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 1:269 LOCUST ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2003
Mailing Address - Country:US
Mailing Address - Phone:413-586-0769
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL CENTER DR STE 406
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107
Practice Address - Country:US
Practice Address - Phone:413-732-1119
Practice Address - Fax:413-732-5038
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA274037207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program