Provider Demographics
NPI:1447215611
Name:GOREJA, ARIF (MD)
Entity Type:Individual
Prefix:
First Name:ARIF
Middle Name:
Last Name:GOREJA
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 1:3245 HEALTH DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-3245
Mailing Address - Country:US
Mailing Address - Phone:547-647-1840
Mailing Address - Fax:
Practice Address - Street 1:2235 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-3529
Practice Address - Country:US
Practice Address - Phone:574-647-4530
Practice Address - Fax:574-647-2285
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072001A207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201131770Medicaid
INP01286888OtherRR MEDICARE
IN000000884795OtherBCBS ELKHART EAST
IN000000857586OtherBCBS BMG GOSHEN
IN000000905581OtherBCBS BMG KIDNEY & HYPERTENSION
IN000000805545OtherBCBS BMG SCHWARTZ
IN169380075OtherMEDICARE PTAN
IN201131770Medicaid
IN000000815204OtherBCBS LAPORTE
IN000000905581OtherBCBS BMG KIDNEY & HYPERTENSION
IN169380075OtherMEDICARE PTAN
WV4130432Medicare PIN
OH2469565Medicaid
IN000000805545OtherBCBS BMG SCHWARTZ
IN000000884795OtherBCBS ELKHART EAST