Provider Demographics
NPI:1932135548
Name:SUREJA, NAGJI J (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGJI
Middle Name:J
Last Name:SUREJA
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 1:4212 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7849
Mailing Address - Country:US
Mailing Address - Phone:410-795-3800
Mailing Address - Fax:410-795-3817
Practice Address - Street 1:4212 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7849
Practice Address - Country:US
Practice Address - Phone:410-795-3800
Practice Address - Fax:410-795-3817
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD22663207QG0300X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD22663OtherMARYLAND STATE LIC
MDD22663OtherMARYLAND STATE LIC
MDD48329Medicare UPIN
MDAS8447371OtherDEA LIC.