MEDICARE: DR. AHMAD BADR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	DR.0071528	CO

General Provider Information

NPI Number	:	1124474713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMAD BADR M.D.

Provider Business Mailing Address
First Line	:	50 RAVENGLASS WAY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-7965
Country	:	US
Telephone Number	:	518-565-0202
Fax Number	:	719-982-8825

Provider Business Practice Location Address
First Line	:	455 E PIKES PEAK AVE STE 306
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-3648
Country	:	US
Telephone Number	:	719-401-2608
Fax Number	:	719-982-8805

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2016
Last Update Date	:	08/25/2025

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