MEDICARE: BADGER CARE LLC

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	208D00000X	General Practice Physician	53833	WI

General Provider Information

NPI Number	:	1578850699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BADGER CARE LLC

Provider Business Mailing Address
First Line	:	9009 N WHITE OAK LN
Second Line	:	#226
City	:	BAYSIDE
State	:	WI
Zip	:	53217-6201
Country	:	US
Telephone Number	:	347-276-9281
Fax Number	:	414-247-9004

Provider Business Practice Location Address
First Line	:	1300 S GREEN BAY RD
Second Line	:	#205
City	:	MOUNT PLEASANT
State	:	WI
Zip	:	53406-4469
Country	:	US
Telephone Number	:	347-276-9281
Fax Number	:	414-247-9004

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. SALAM U SYED
Credential	:	MD
Telephone Number	:	347-276-9281

Provider Enumeration Date	:	07/10/2011
Last Update Date	:	07/10/2011

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Directions to “BADGER CARE LLC ” Practice Location

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