Provider Demographics
NPI:1639269046
Name:MENON, ROJI (MD)
Entity Type:Individual
Prefix:
First Name:ROJI
Middle Name:
Last Name:MENON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10901 CONNECTICUT AVE
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895
Mailing Address - Country:US
Mailing Address - Phone:301-942-7900
Mailing Address - Fax:301-942-9837
Practice Address - Street 1:10901 CONNECTICUT AVE
Practice Address - Street 2:SUITE # 100
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895
Practice Address - Country:US
Practice Address - Phone:301-942-7900
Practice Address - Fax:301-942-9837
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0057879207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
133505OtherPTAN
H46651Medicare UPIN
133505OtherPTAN