Provider Demographics
NPI:1740261296
Name:PAI, AJIT V (MD)
Entity type:Individual
Prefix:DR
First Name:AJIT
Middle Name:V
Last Name:PAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-0126
Mailing Address - Country:US
Mailing Address - Phone:574-251-0498
Mailing Address - Fax:574-251-0068
Practice Address - Street 1:3212 HICKORY RD
Practice Address - Street 2:SUITE B
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-8863
Practice Address - Country:US
Practice Address - Phone:574-251-0498
Practice Address - Fax:574-251-0068
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01028758A208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200005460BMedicaid
INC25571Medicare UPIN
IN200005460BMedicaid