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Individual

DR. MONUJ TRIVEN BASHAMBU

Active
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Individual

DR. MONUJ TRIVEN BASHAMBU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
LL29238
SC
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
068983
GA
2080N0001X
Neonatal-Perinatal Medicine Physician
35.094111
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000785511
ANTHEM
OH
05
—
0072631
—
OH
01
—
35.094111
LICENSE
OH
01
—
9105965
AETNA
OH
Enumeration date
10/13/2006
Last updated
08/16/2013
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