1467426718 NPI number — VINAY BADHWAR MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467426718 NPI number — VINAY BADHWAR MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

BADHWAR

Provider First Name:

VINAY

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1467426718

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/08/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1 MEDICAL CENTER DRIVE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MORGANTOWN

Provider Business Mailing Address State Name:

WV

Provider Business Mailing Address Postal Code:

26506-1200

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

304-598-4800

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

1 MEDICAL CENTER DRIVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

MORGANTOWN

Provider Business Practice Location Address State Name:

WV

Provider Business Practice Location Address Postal Code:

26506-1200

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

304-598-4800

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

02/14/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208G00000X , with the licence number:  MD444207 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208G00000X , with the licence number: ME85670 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208G00000X , with the licence number: 27008 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 134223953 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 62904 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 0843074 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 3306888 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 202337 . This is a "STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 2221703 . This is a "UNITED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 284915 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 202337 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 265720100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".