Provider Demographics
NPI:1205401551
Name:BABUJI, ASHWIN (DO)
Entity type:Individual
Prefix:DR
First Name:ASHWIN
Middle Name:
Last Name:BABUJI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3624 FARM BELL PL
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4111
Mailing Address - Country:US
Mailing Address - Phone:407-529-4693
Mailing Address - Fax:
Practice Address - Street 1:ONE GENESYS PARKWAY
Practice Address - Street 2:ASCENSION GENESYS HOSPITAL, OFFICE OF MEDICAL EDUCATION
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439
Practice Address - Country:US
Practice Address - Phone:810-606-5985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151014929207Q00000X
NY328745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty