Doctor Name: | DR. THEJESWI PUJAR |
NPI Number: | 1407008055 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | A111563 |
Business Practice Address: | 1825 Logan Ave Allen Hospital Waterloo, IA - 507031916 |
Business Phone Number: | 3192344431 |
Business Fax Number: | |
Mailing Address: | 1402 Quail Ridge Rd, CEDAR FALLS |
State: | IA |
Postal Code: | 506134934 |
Phone Number: | 7742532457 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2008 |
NPI Last Update Date: | 10/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | A111563 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |