Provider Demographics
NPI:1548432792
Name:RAJKUMAR G BHOJRAJ M.D.
Entity Type:Organization
Organization Name:RAJKUMAR G BHOJRAJ M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJKUMAR
Authorized Official - Middle Name:GOVIND
Authorized Official - Last Name:BHOJRAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-498-9300
Mailing Address - Street 1:704 GORMAN AVE
Mailing Address - Street 2:#T1
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-3947
Mailing Address - Country:US
Mailing Address - Phone:301-498-9300
Mailing Address - Fax:
Practice Address - Street 1:704 GORMAN AVE
Practice Address - Street 2:#T1
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-3947
Practice Address - Country:US
Practice Address - Phone:301-498-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD23181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402765500Medicaid
MD402765501Medicaid
G01367Medicare PIN
MDC88820Medicare UPIN