Provider Demographics
NPI:1396033700
Name:BAJWA, RAVNEET (MD)
Entity Type:Individual
Prefix:
First Name:RAVNEET
Middle Name:
Last Name:BAJWA
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 1:401 E CHEVES ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2615
Mailing Address - Country:US
Mailing Address - Phone:843-777-7951
Mailing Address - Fax:843-777-7981
Practice Address - Street 1:401 E CHEVES ST STE 201
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2615
Practice Address - Country:US
Practice Address - Phone:843-777-7951
Practice Address - Fax:843-777-7981
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40697207RH0003X
FLTRN15797207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine