Provider Demographics
NPI:1609043579
Name:MUNEER, BADAR (MD)
Entity type:Individual
Prefix:DR
First Name:BADAR
Middle Name:
Last Name:MUNEER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 RACETRACK RD NW STE 100B
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1796
Mailing Address - Country:US
Mailing Address - Phone:850-357-8151
Mailing Address - Fax:239-343-4159
Practice Address - Street 1:320 RACETRACK RD NW STE 100B
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1796
Practice Address - Country:US
Practice Address - Phone:850-357-8151
Practice Address - Fax:850-362-6060
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101980207RG0100X, 207RG0100X
OH35.099261207RI0008X
VA0101266408207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022666300Medicaid
OH0065336Medicaid
IN201356650Medicaid
FL022666300Medicaid
IN000001014992OtherANTHEM PROVIDER NUMBER
INP01714276Medicare PIN