MEDICARE: DR. SUHAS BADARINATH MD

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	208VP0000X	Pain Medicine Physician	ME155546	FL
2	208VP0000X	Pain Medicine Physician	D0078317	MD
3	208100000X	Physical Medicine & Rehabilitation Physician	P20519	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME155546	OTHER	FL	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8W5187	OTHER		BLUE CROSS BLUE SHIELD OF TX

General Provider Information

NPI Number	:	1821133323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUHAS BADARINATH MD

Provider Business Mailing Address
First Line	:	1100 ROUTE 70
Second Line	:
City	:	WHITING
State	:	NJ
Zip	:	08759-1003
Country	:	US
Telephone Number	:	732-849-0077
Fax Number	:	732-849-0015

Provider Business Practice Location Address
First Line	:	2702 BACK ACRE CIR STE 290B
Second Line	:
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-7769
Country	:	US
Telephone Number	:	301-703-8767
Fax Number	:	301-703-8766

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	01/17/2024

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Directions to “ DR. SUHAS BADARINATH MD” Practice Location

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