Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 4301085575 | MI |
NPI | 1326253170 |
---|---|
Provider Name | Sunil Kumar Bajaj |
First Address | Royal Oak, MI 48073 |
Second Address | Royal Oak, MI 48073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 30/04/2012 |