Provider Demographics
NPI:1689669590
Name:PAHWA, RAJIT (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJIT
Middle Name:
Last Name:PAHWA
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 1:1200 E MICHIGAN AVE STE 530
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1800
Mailing Address - Country:US
Mailing Address - Phone:517-364-5880
Mailing Address - Fax:517-364-5887
Practice Address - Street 1:1200 E MICHIGAN AVE STE 530
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1800
Practice Address - Country:US
Practice Address - Phone:517-364-5880
Practice Address - Fax:517-364-5887
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065677208M00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4737375Medicaid
MI4737384Medicaid
MI4737393Medicaid
MI08OG21014OtherBCBS
H48009Medicare UPIN
MI4737375Medicaid