Healthcare Provider Details

I. General information

NPI: 1396395992
Provider Name (Legal Business Name): SANDEEP BRAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 09/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 29 STREET NW
CALGARY ALBERTA
T2N 2T9
CA

IV. Provider business mailing address

4515 88 AVENUE NE
CALGARY ALBERTA
T3J 4C5
CA

V. Phone/Fax

Practice location:
  • Phone: 403-944-8428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA158583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: