Provider Demographics
NPI:1326095100
Name:ROSBOROUGH, RANIA BAJWA (MD)
Entity Type:Individual
Prefix:
First Name:RANIA
Middle Name:BAJWA
Last Name:ROSBOROUGH
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 1:2000 HEALTH PARK DR FL HP2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4692
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:877-767-2310
Practice Address - Street 1:614 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-1818
Practice Address - Country:US
Practice Address - Phone:540-731-1600
Practice Address - Fax:540-731-0720
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063732207R00000X
VA0101257197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI45359Medicare UPIN
MD657LM865Medicare ID - Type Unspecified