Individual
TARIF BAKDASH
Active
Individual
TARIF BAKDASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
12298
MT
208000000X
Pediatrics Physician
2012014535
MO
208000000X
Pediatrics Physician
4301055614
MI
2084N0400X
Neurology Physician
63034
WI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
24539
MS
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
4301055614
MI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
58549
KY
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
63034
WI
2084N0600X
Clinical Neurophysiology Physician
58549
KY
2084N0600X
Clinical Neurophysiology Physician
63034
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05127841
—
MS
05
—
1104141712
—
MO
01
—
12298
LICENSE
MT
05
—
192753001
—
AR
05
—
200435170A
—
OK
01
—
431560263
TRICARE
MO
01
—
P01110482
RR MCR
MO
Enumeration date
04/07/2010
Last updated
11/02/2023
Update your record
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