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General NPI Number Information
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NPI Number | 1861677056
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Entity Type | Organization
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Legal Business Name | MADHUMITA BHOJRAJ MD,PC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 6111 HARRISON ST SUITE 225
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City | MERRILLVILLE
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State | IN
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Zip | 46410-2969
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Country | US
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Telephone | 219-887-8000
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Fax | 219-887-8815
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Provider Business Mailing Address
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Address Line | 6111 HARRISON ST SUITE 225
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City | MERRILLVILLE
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State | IN
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Zip | 46410-2969
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Country | US
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Telephone | 219-887-8000
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Fax | 219-887-8815
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | MADHUMITA BHOJRAJ
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Credential | MD
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Telephone | 219-887-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01032331A
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License Number State | IN
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