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General NPI Number Information
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NPI Number | 1124244637
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Entity Type | Individual
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Provider Name | KHALED IQBAL EL-BADAWI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 401 YOUNG AVE STE FRNT
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3130
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Country | US
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Telephone | 856-247-7295
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Fax | 856-291-8791
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-247-7295
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Fax | 856-291-8791
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 4301093360
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 25MA08776100
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License Number State | NJ
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