=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548432792
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAJKUMAR G BHOJRAJ M.D.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2008
-----------------------------------------------------
Last Update Date | 06/05/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 704 GORMAN AVE #T1
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20707-3947
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-498-9300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 704 GORMAN AVE #T1
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20707-3947
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-498-9300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. RAJKUMAR GOVIND BHOJRAJ
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 301-498-9300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | D23181
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------