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General NPI Number Information
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NPI Number | 1942467840
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Entity Type | Organization
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Legal Business Name | SUDHIR G. BAJI, M.D. , INC.
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 1700 E MARKET ST SUITE# 110
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City | WARREN
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State | OH
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Zip | 44483-6625
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Country | US
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Telephone | 330-394-4755
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Fax | 330-399-4602
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Provider Business Mailing Address
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Address Line | 1700 E MARKET ST SUITE # 110
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City | WARREN
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State | OH
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Zip | 44483-6625
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Country | US
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Telephone | 330-394-4755
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Fax | 330-399-4602
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUDHIR G BAJI
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Credential | M.D.
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Telephone | 330-394-4755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 35-039458
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License Number State | OH
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