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General NPI Number Information
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NPI Number | 1124297361
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Entity Type | Individual
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Provider Name | REJMON DEDAJ M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 2609 NEW HARTFORD RD
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City | OWENSBORO
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State | KY
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Zip | 42303-1316
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Country | US
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Telephone | 270-215-3140
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Fax | 270-240-4820
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Provider Business Mailing Address
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Address Line | PO BOX 3407
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City | EVANSVILLE
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State | IN
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Zip | 47733-3407
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Country | US
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Telephone | 812-450-6815
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Fax | 812-450-6822
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 01083334A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 46072
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License Number State | KY
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