Provider Demographics
NPI:1689240657
Name:BAJAJ, KUNAL (MD)
Entity Type:Individual
Prefix:MR
First Name:KUNAL
Middle Name:
Last Name:BAJAJ
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 1:4201 ST. ANTOINE DMC GME OFFICE
Mailing Address - Street 2:UHC-9C
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-745-5146
Mailing Address - Fax:313-966-0880
Practice Address - Street 1:CHILDREN'S HOSPITAL OF MICHIGAN
Practice Address - Street 2:3901 BEAUBIEN STREET
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2023-04-20
Deactivation Date:2023-03-31
Deactivation Code:
Reactivation Date:2023-04-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program