Individual
DR. SYED G BADRUDDUJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 UNIVERSITY DR STE 203, PRESTONSBURG, KY 41653-1080
(606) 886-8183
(606) 886-0575
Mailing address
400 UNIVERSITY DR STE 203, PRESTONSBURG, KY 41653-1080
(606) 886-8183
(606) 886-0575
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17825
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057545
BLUE CROSS PROVIDER NUMBE
KY
05
—
65901951
—
KY
Enumeration date
12/18/2006
Last updated
10/29/2007
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