Individual
GURNAM S BAJWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2206A WILBORN AVE, SOUTH BOSTON, VA 24592
(434) 572-2744
(434) 572-2785
Mailing address
2206A WILBORN AVE, SOUTH BOSTON, VA 24592
(434) 572-2744
(434) 572-2785
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101027276
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007313527
—
VA
01
—
292847
ANTHEM BCBS
VA
Enumeration date
08/01/2006
Last updated
11/17/2009
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