Provider Demographics
NPI:1790850766
Name:CARDIO-PULMONARY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CARDIO-PULMONARY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIRAJUDDIN
Authorized Official - Middle Name:SYED
Authorized Official - Last Name:KHAJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-8600
Mailing Address - Street 1:PO BOX 3369
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-0369
Mailing Address - Country:US
Mailing Address - Phone:219-836-8600
Mailing Address - Fax:
Practice Address - Street 1:921 FRAN LIN PKWY
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3540
Practice Address - Country:US
Practice Address - Phone:219-836-0488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN706890Medicare ID - Type Unspecified