Healthcare Provider Details
I. General information
NPI: 1467401349
Provider Name (Legal Business Name): BAJAJ ELECTROPHYSIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3243 E MURDOCK ST SUITE #510
WICHITA KS
67208-3052
US
IV. Provider business mailing address
3243 E MURDOCK ST SUITE #510
WICHITA KS
67208-3052
US
V. Phone/Fax
- Phone: 316-683-4800
- Fax: 316-683-4810
- Phone: 316-683-4800
- Fax: 316-683-4810
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ASHOK
K
BAJAJ
Title or Position: PRESIDENT
Credential: MD
Phone: 316-683-4800