Provider Demographics
NPI:1629388822
Name:NAGJI SUREJA, M.D., P.A.
Entity Type:Organization
Organization Name:NAGJI SUREJA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGJI
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUREJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-795-3800
Mailing Address - Street 1:4212 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7849
Mailing Address - Country:US
Mailing Address - Phone:410-795-3800
Mailing Address - Fax:410-795-3817
Practice Address - Street 1:4212 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7849
Practice Address - Country:US
Practice Address - Phone:410-795-3800
Practice Address - Fax:410-795-3817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022663174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD080005448OtherRAILROAD MEDICARE
MD8393Medicare PIN