Individual
UJJWAL DHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(601) 200-4714
(601) 200-4718
Mailing address
PO BOX 23666, JACKSON, MS 39225-3666
(601) 200-4749
(601) 200-5929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37134
TN
207RI0200X
Infectious Disease Physician
20776
MS
207RI0200X
Infectious Disease Physician
Primary
37134
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03900372
—
MS
01
—
29136
TLC
TN
05
—
3328251
—
TN
01
—
4099087
BLUE CROSS BLUE SHIELD
TN
01
—
P01059006
RAILROAD MEDICARE
MS
Enumeration date
07/08/2006
Last updated
06/17/2016
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