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NPI Code Detail

MEDICARE: DR. BALRAJ BAWA M.D.

MEDICARE: DR. BALRAJ BAWA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0101028762VA

General Provider Information

NPI Number : 1053327536
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BALRAJ BAWA M.D.
Provider Business Mailing Address
First Line : 2705 FARMINGTON PL
Second Line :
City : LYNCHBURG
State : VA
Zip : 24503-2921
Country : US
Telephone Number : 434-384-8228
Fax Number : 434-947-2906
Provider Business Practice Location Address
First Line : 521 COLONY RD
Second Line :
City : MADISON HEIGHTS
State : VA
Zip : 24572-2105
Country : US
Telephone Number : 434-947-6320
Fax Number : 434-947-2906
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 07/08/2007

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