Healthcare Provider Details

I. General information

NPI: 1356071229
Provider Name (Legal Business Name): GURMAN SINGH DHALIWAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 N HIGLEY RD, STE 106
GILBERT AZ
85234
US

IV. Provider business mailing address

1920 N HIGLEY RD, STE 106
GILBERT AZ
85234
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-6444
  • Fax: 480-256-3682
Mailing address:
  • Phone: 480-256-6444
  • Fax: 480-256-3682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number70390
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR79387
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: