Provider Demographics
NPI:1235446352
Name:NIJJAR, SATNAM SINGH (MD, FRCPC)
Entity Type:Individual
Prefix:
First Name:SATNAM
Middle Name:SINGH
Last Name:NIJJAR
Suffix:
Gender:M
Credentials:MD, FRCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 PRESIDENT ST
Mailing Address - Street 2:APT. 1318
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4474
Mailing Address - Country:US
Mailing Address - Phone:410-550-1446
Mailing Address - Fax:410-550-0539
Practice Address - Street 1:301 MASON LORD DR
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-3057
Practice Address - Country:US
Practice Address - Phone:410-550-1446
Practice Address - Fax:410-550-0539
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD71372282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD036634000Medicaid
MD036634000Medicaid