Provider Demographics
NPI:1568482404
Name:BHOJRAJ, MADHUMITA (MD)
Entity Type:Individual
Prefix:MS
First Name:MADHUMITA
Middle Name:
Last Name:BHOJRAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MITA
Other - Middle Name:
Other - Last Name:BHOJRAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6091 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410
Mailing Address - Country:US
Mailing Address - Phone:219-763-8112
Mailing Address - Fax:219-884-2547
Practice Address - Street 1:6091 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2619
Practice Address - Country:US
Practice Address - Phone:219-763-8112
Practice Address - Fax:219-884-2547
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032331A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10780356OtherCAQH
IN200275500BMedicaid
IN10780356OtherCAQH
IN226710 GROUP NUMBERMedicare UPIN
INH18467Medicare UPIN