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NPI Code Detail

MEDICARE: SUNDEEP SINGH BAJWA DO

MEDICARE: SUNDEEP SINGH BAJWA DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician04754KY
2207R00000XInternal Medicine Physician34-013821OH
3208M00000XHospitalist Physician04754KY

General Provider Information

NPI Number : 1417486374
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNDEEP SINGH BAJWA DO
Provider Business Mailing Address
First Line : PO BOX 635283
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-5283
Country : US
Telephone Number : 859-344-5555
Fax Number : 859-212-4357
Provider Business Practice Location Address
First Line : 85 N GRAND AVE
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-4027
Country : US
Telephone Number : 859-301-8074
Fax Number : 859-301-4945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2017
Last Update Date : 12/19/2023

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Directions to “ SUNDEEP SINGH BAJWA DO” Practice Location

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