Provider Demographics
NPI:1609578293
Name:AHUJA, SHAWN (MD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:AHUJA
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 1:101 MANNING DRIVE CB# 7510
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7510
Mailing Address - Country:US
Mailing Address - Phone:984-974-1884
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DRIVE CB# 7510
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7510
Practice Address - Country:US
Practice Address - Phone:984-974-1884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAHUJ-6K4K8O390200000X
NC2024-034092085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program