Provider Demographics
NPI:1396958062
Name:BAJWA, KOMALPREET KAUR (MD)
Entity type:Individual
Prefix:
First Name:KOMALPREET
Middle Name:KAUR
Last Name:BAJWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KOMALPREET
Other - Middle Name:KAUR
Other - Last Name:BHULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:983075 NEBRASKA MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-3075
Mailing Address - Country:US
Mailing Address - Phone:402-559-7249
Mailing Address - Fax:402-559-6501
Practice Address - Street 1:983075 NEBRASKA MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3075
Practice Address - Country:US
Practice Address - Phone:402-559-7249
Practice Address - Fax:402-559-6501
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine