Provider Demographics
NPI:1033176383
Name:PAHUJA, KRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:
Last Name:PAHUJA
Suffix:
Gender:F
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:PO BOX 704
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46325-0704
Mailing Address - Country:US
Mailing Address - Phone:219-933-4889
Mailing Address - Fax:219-933-3153
Practice Address - Street 1:4020 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1129
Practice Address - Country:US
Practice Address - Phone:219-933-4889
Practice Address - Fax:219-933-3153
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000227440OtherBLUE SHIELD
IL0090001298OtherBLUE CROSS BLUE SHIELD IL
IN010036025OtherRAILROAD MEDICARE
IN100206510AMedicaid
INC25487Medicare UPIN
IN010036025OtherRAILROAD MEDICARE
IN100206510AMedicaid