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General NPI Number Information
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NPI Number | 1306914320
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Entity Type | Individual
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Provider Name | KHALID M BAJWA MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 301 SPRING GARDEN RD ANCORA PSYCHIATRIC HOSPITAL
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City | HAMMONTON
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State | NJ
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Zip | 08037-2516
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Country | US
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Telephone | 609-561-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 5 STRATTON LN
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City | SEWELL
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State | NJ
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Zip | 08080-2549
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Country | US
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Telephone | 856-232-7131
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MA073090
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License Number State | NJ
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