Provider Demographics
NPI:1639175565
Name:AHUJA, RAJENDER (MD)
Entity Type:Individual
Prefix:
First Name:RAJENDER
Middle Name:
Last Name:AHUJA
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 1:3000 REGENCY CT
Mailing Address - Street 2:STE 207
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3092
Mailing Address - Country:US
Mailing Address - Phone:419-471-0493
Mailing Address - Fax:419-474-0390
Practice Address - Street 1:3000 REGENCY CT
Practice Address - Street 2:STE 207
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3092
Practice Address - Country:US
Practice Address - Phone:419-471-0493
Practice Address - Fax:419-474-0390
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350468172085R0001X
MI43010572022085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0493667Medicaid
MI4153868OtherMI MEDICAID - OH LOCATIONS
OH920005070OtherRR MEDICARE
MI4282927Medicaid
MI920006290OtherRR MEDICARE
MI0N24000001OtherMEDICARE
MI920006290OtherRR MEDICARE
MI4153868OtherMI MEDICAID - OH LOCATIONS
MI4282927Medicaid