Individual
ANITA M. BAJAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3998 RED LION ROAD, PHILADELPHIA, PA 19114-1436
(215) 612-4021
Mailing address
4 NESHAMINY INTERPLEX, SUITE 209, TREVOSE, PA 19053-6940
(215) 244-3070
(215) 638-9041
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A44672
CA
2085R0202X
Diagnostic Radiology Physician
Primary
MD436119
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A446720
BLUE SHIELD
CA
05
—
00A446720
—
CA
05
—
102248295-0001
—
PA
05
—
GR0106037
—
CA
Enumeration date
06/04/2006
Last updated
05/26/2009
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