Provider Demographics
NPI:1942829742
Name:BADSHAH, MASHOOD BIN (MD)
Entity type:Individual
Prefix:
First Name:MASHOOD
Middle Name:BIN
Last Name:BADSHAH
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 1:1708 W GENEVA RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-1182
Mailing Address - Country:US
Mailing Address - Phone:516-605-5175
Mailing Address - Fax:
Practice Address - Street 1:3901 PINE LAKE RD STE 120
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5497
Practice Address - Country:US
Practice Address - Phone:402-420-3414
Practice Address - Fax:402-328-0961
Is Sole Proprietor?:No
Enumeration Date:2020-04-11
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE36954207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology