Provider Demographics
NPI:1699730465
Name:BAJWA, RABIA (MD)
Entity type:Individual
Prefix:
First Name:RABIA
Middle Name:
Last Name:BAJWA
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 1:850 HOSPITAL RD
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3662
Mailing Address - Country:US
Mailing Address - Phone:724-349-8825
Mailing Address - Fax:724-349-8826
Practice Address - Street 1:850 HOSPITAL RD STE 2400
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3663
Practice Address - Country:US
Practice Address - Phone:724-349-8825
Practice Address - Fax:724-349-8826
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069735L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017913850004Medicaid
PA036257SBDOtherMEDICARE GROUP
PA0017913850004Medicaid