MEDICARE: AJAY SINGH BAJWA 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
1	207RC0000X	Cardiovascular Disease Physician	200200490	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00223116	OTHER	NC	RAILROAD MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548256332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJAY SINGH BAJWA M.D.

Provider Business Mailing Address
First Line	:	2240 REMOUNT RD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-4725
Country	:	US
Telephone Number	:	704-671-5311
Fax Number	:	704-671-5308

Provider Business Practice Location Address
First Line	:	2555 COURT DR
Second Line	:	SUITE 200
City	:	GASTONIA
State	:	NC
Zip	:	28054-2134
Country	:	US
Telephone Number	:	704-867-2141
Fax Number	:	704-867-2308

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	03/01/2010

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