Healthcare Provider Details

I. General information

NPI: 1144484007
Provider Name (Legal Business Name): BADRI GIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CRYSTAL SPRING AVE SW STE 300
ROANOKE VA
24014-2465
US

IV. Provider business mailing address

2001 CRYSTAL SPRING AVE SW STE 300
ROANOKE VA
24014-2465
US

V. Phone/Fax

Practice location:
  • Phone: 540-985-8505
  • Fax: 540-344-3313
Mailing address:
  • Phone: 540-985-8505
  • Fax: 540-344-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101264551
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101264551
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: