Provider Demographics
NPI:1124010400
Name:PAHUJA, DEEPAK (MD, MBBS, FACP)
Entity Type:Individual
Prefix:DR
First Name:DEEPAK
Middle Name:
Last Name:PAHUJA
Suffix:
Gender:M
Credentials:MD, MBBS, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 MAIN ST STE 233
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4463
Mailing Address - Country:US
Mailing Address - Phone:810-610-7726
Mailing Address - Fax:814-453-2698
Practice Address - Street 1:2770 MAIN ST STE 233
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4463
Practice Address - Country:US
Practice Address - Phone:888-492-0254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90837207R00000X
MI4301077930207R00000X
PAMD426930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017347570002Medicaid
PA001746825OtherHIGHMARK
PA098764Medicare PIN