MEDICARE: SHAMIRAM BADAL 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	390200000X	Student in an Organized Health Care Education/Training Program	125053883	IL
2	207Q00000X	Family Medicine Physician	A113428	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000789617	OTHER	IN	BCBS
2	125053883	OTHER	IL	STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	01070305A	OTHER	IN	IN STATE ID
5	000000856561	OTHER	IN	BCBS NW

General Provider Information

NPI Number	:	1760629307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMIRAM BADAL M.D.

Provider Business Mailing Address
First Line	:	5215 HOLY CROSS PKWY
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46545-1469
Country	:	US
Telephone Number	:	574-335-8700
Fax Number	:	574-335-0760

Provider Business Practice Location Address
First Line	:	2930 W CLEVELAND RD
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46628-6090
Country	:	US
Telephone Number	:	574-335-8450
Fax Number	:	574-335-0760

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

Provider Enumeration Date	:	01/20/2009
Last Update Date	:	01/13/2026

Similar Medicare Providers

1881696383 — DR. FRANK V. MURPHY M.D.
Practice Location Address:

2930 W CLEVELAND RD
SOUTH BEND, IN
46628-6090

Practice Phone: 574-335-8450
Practice Fax: 574-335-0780

1104863679 — RICHARD A STOLDT M.D.
Practice Location Address:

2930 W CLEVELAND RD
SOUTH BEND, IN
46628-6090

Practice Phone: 574-520-2707
Practice Fax: 574-520-2700

1437191665 — MICHAEL HELMS M.D.
Practice Location Address:

2930 W CLEVELAND RD
SOUTH BEND, IN
46628-6090

Practice Phone: 574-335-8450
Practice Fax: 574-335-0780

1538746284 — JORDAN HATCH MD
Practice Location Address:

2930 W CLEVELAND ROAD EXT
SOUTH BEND, IN
46628-6090

Practice Phone: 574-335-8450
Practice Fax: 574-335-0780

1144807785 — MR. DANIEL QUINN MINTER IV
Practice Location Address:

2930 W CLEVELAND ROAD EXT
SOUTH BEND, IN
46628-6090

Practice Phone: 574-335-8450
Practice Fax: 574-335-0780

1720228794 — MRS. NICOLE C SEIDENTHAL ARNP
Practice Location Address:

6090 SW 78 STREET
SOUTH MIAMI, FL
33143

Practice Phone: 305-796-5593
Practice Fax:

Directions to “ SHAMIRAM BADAL M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.