Individual
ATA UR RAHIM BAJWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 HARRISON ST STE 250, JOHNSON CITY, NY 13790-2176
(607) 763-6580
Mailing address
33 LEWIS RD, 2ND FL, BINGHAMTON, NY 13905
(607) 770-0025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2015025971
MO
207RC0000X
Cardiovascular Disease Physician
315193
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
315193
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
MT221839
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508123688
—
MO
Enumeration date
04/13/2012
Last updated
07/26/2023
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