Healthcare Provider Details

I. General information

NPI: 1710398854
Provider Name (Legal Business Name): ANDREW AMIT BAJAJ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27850 GRATIOT AVE
ROSEVILLE MI
48066-4803
US

IV. Provider business mailing address

27850 GRATIOT AVE
ROSEVILLE MI
48066-4803
US

V. Phone/Fax

Practice location:
  • Phone: 586-772-5876
  • Fax: 586-772-1122
Mailing address:
  • Phone: 586-772-5876
  • Fax: 586-772-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301010049
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: