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General NPI Number Information
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NPI Number | 1952335382
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Entity Type | Individual
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Provider Name | MEHTAB SINGH BAJWA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 301 YADKIN ST
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City | ALBEMARLE
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State | NC
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Zip | 28001-3441
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Country | US
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Telephone | 980-993-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 6135 PARK SOUTH DR STE 510
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City | CHARLOTTE
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State | NC
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Zip | 28210-0100
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Country | US
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Telephone | 704-749-3116
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 236419-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2022-00999
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License Number State | NC
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