Provider Demographics
NPI:1154400448
Name:MAJUMDER, INDIRA (MD)
Entity type:Individual
Prefix:MRS
First Name:INDIRA
Middle Name:
Last Name:MAJUMDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 PINEVIEW DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-599-2441
Mailing Address - Fax:304-598-9401
Practice Address - Street 1:1189 PINEVIEW DR
Practice Address - Street 2:SUITE E
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-599-2441
Practice Address - Fax:304-598-9401
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10709208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0110473000Medicaid