Provider Demographics
NPI:1366446619
Name:AHUJA, KANWALJIT SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:KANWALJIT
Middle Name:SINGH
Last Name:AHUJA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 SUPERIOR LN STE A8
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1939
Mailing Address - Country:US
Mailing Address - Phone:301-352-6126
Mailing Address - Fax:301-352-6127
Practice Address - Street 1:3231 SUPERIOR LN STE A8
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1939
Practice Address - Country:US
Practice Address - Phone:301-352-6126
Practice Address - Fax:301-352-6127
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00061462084N0400X
MDD00578472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD699234000Medicaid
DC036476200Medicaid
DE0001166401Medicaid
491938Medicare ID - Type Unspecified
DCGO1858P01Medicare ID - Type Unspecified
DE0001166401Medicaid