Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301086467 | MI |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 4301086467 | MI |
NPI | 1104029370 |
---|---|
Provider Name | Monika Bajaj |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 29/01/2010 |