Provider Demographics
NPI:1952313314
Name:BAJUYO, MARIA A (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:BAJUYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 WINFIELD CT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-3609
Mailing Address - Country:US
Mailing Address - Phone:317-925-2229
Mailing Address - Fax:
Practice Address - Street 1:1255 WINFIELD CT
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3609
Practice Address - Country:US
Practice Address - Phone:317-925-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060988A207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400060583OtherMEDICARE
IN200524010Medicaid