MEDICARE: AMAN MAHAJAN 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	2084P0800X	Psychiatry Physician	62762-20	WI
2	2084P0804X	Child & Adolescent Psychiatry Physician	036132860	IL

General Provider Information

NPI Number	:	1932411584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMAN MAHAJAN M.D

Provider Business Mailing Address
First Line	:	4600 W SCHROEDER DR
Second Line	:	ROGERS MEMORIAL HOSPITAL
City	:	BROWN DEER
State	:	WI
Zip	:	53223-1469
Country	:	US
Telephone Number	:	414-865-2500
Fax Number	:	414-797-0804

Provider Business Practice Location Address
First Line	:	4600 W SCHROEDER DR
Second Line	:	ROGERS MEMORIAL HOSPITAL
City	:	BROWN DEER
State	:	WI
Zip	:	53223-1469
Country	:	US
Telephone Number	:	414-865-2500
Fax Number	:	414-797-0804

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

Provider Enumeration Date	:	07/12/2010
Last Update Date	:	06/23/2015

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