Individual
MOAVIZ BADSHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-1283
(347) 820-4801
Mailing address
1708 W GENEVA RD, PEORIA, IL 61615-1182
(347) 820-4801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.152988
IL
208M00000X
Hospitalist Physician
Primary
036.152988
IL
Other
Enumeration date
02/14/2017
Last updated
09/03/2020
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