Individual
DR. RAGHUBINDER K BAJWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
490 BLUE HILLS AVE, SUITE 103, HARTFORD, CT 06112
(608) 714-2647
(608) 714-8517
Mailing address
490 BLUE HILLS AVE, HARTFORD, CT 06112
(608) 714-2647
(860) 714-8517
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
29145
CT
208100000X
Physical Medicine & Rehabilitation Physician
Primary
60569
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3051323
—
MA
01
—
J08214
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/16/2006
Last updated
11/11/2021
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