Healthcare Provider Details

I. General information

NPI: 1710483342
Provider Name (Legal Business Name): BRYAN DAVID BADAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR
DURHAM NC
27710-0001
US

IV. Provider business mailing address

40 DUKE MEDICINE CIR
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-1817
  • Fax: 919-479-2664
Mailing address:
  • Phone: 919-684-1817
  • Fax: 919-479-2664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2024-01179
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number2024-01179
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: