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General NPI Number Information
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NPI Number | 1629235619
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Entity Type | Individual
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Provider Name | ANISH JAYANTILAL BADODARIYA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 04/24/2009
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Provider Practice Location Address
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Address Line | 5801 BREMO RD
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City | RICHMOND
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State | VA
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Zip | 23226-1907
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Country | US
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Telephone | 804-285-0620
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Fax |
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Provider Business Mailing Address
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Address Line | 400 CAMELOT CT APT. 401
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City | PITTSBURGH
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State | PA
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Zip | 15220-2551
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Country | US
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Telephone | 412-207-7800
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT186610
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License Number State | PA
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