Provider Demographics
NPI:1962755827
Name:BAJWA, JAWAD M (MD)
Entity type:Individual
Prefix:DR
First Name:JAWAD
Middle Name:M
Last Name:BAJWA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 ILIFF DR
Mailing Address - Street 2:
Mailing Address - City:DUNN LORING
Mailing Address - State:VA
Mailing Address - Zip Code:22027-1235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8000 ILIFF DR
Practice Address - Street 2:
Practice Address - City:DUNN LORING
Practice Address - State:VA
Practice Address - Zip Code:22027-1235
Practice Address - Country:US
Practice Address - Phone:703-942-9878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127778208100000X
VA0101262079208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation