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Individual
MR. BRIAN BADGER
Active
Individual
MR. BRIAN BADGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3435
GA
363AM0700X
Medical Physician Assistant
PA3752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003435
STSTE LICENSE #
GA
05
—
100000360C
—
GA
01
—
606478700
DEPT OF LABOR
FL
01
—
96317
HEALTH PARTNERS
FL
01
—
PA3752
LICENSE #
FL
Enumeration date
07/06/2005
Last updated
02/11/2014
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