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General NPI Number Information
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NPI Number | 1235442963
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Entity Type | Individual
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Provider Name | DHIRAJ BARUAH MD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 22 LLANFAIR RD
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City | ARDMORE
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State | PA
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Zip | 19003-2320
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Country | US
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Telephone | 203-903-2982
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Fax | 775-242-2409
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Provider Business Mailing Address
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Address Line | 22 LLANFAIR RD
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City | ARDMORE
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State | PA
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Zip | 19003-2320
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Country | US
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Telephone | 203-903-2982
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Fax | 775-242-2409
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D0102917
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 82970
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA12374200
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD483642
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License Number State | PA
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