Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35-039458 | OH |
NPI | 1003872235 |
---|---|
Provider Name | Sudhir G Baji |
First Address | Warren, OH 44483-6625 |
Second Address | Warren, OH 44483-6625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000129220 | ANTHEM (01) | OH |
0308045 | (05) | OH |
A75630 | (02) | OH |