MEDICARE: DR. DEEPAK PAHUJA M.D., MBBS, FACP

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
1	207R00000X	Internal Medicine Physician	ME90837	FL
2	207R00000X	Internal Medicine Physician	4301077930	MI
3	207R00000X	Internal Medicine Physician	MD426930	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	001746825	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1124010400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEPAK PAHUJA M.D., MBBS, FACP

Provider Business Mailing Address
First Line	:	2770 MAIN ST STE 233
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-4463
Country	:	US
Telephone Number	:	810-610-7726
Fax Number	:	814-453-2698

Provider Business Practice Location Address
First Line	:	2770 MAIN ST STE 233
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-4463
Country	:	US
Telephone Number	:	888-492-0254
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	08/16/2021

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