Healthcare Provider Details

I. General information

NPI: 1154567352
Provider Name (Legal Business Name): MANPREET SIDHU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19735 GERMANTOWN RD STE 200
GERMANTOWN MD
20874-1217
US

IV. Provider business mailing address

19735 GERMANTOWN RD STE 200
GERMANTOWN MD
20874-1217
US

V. Phone/Fax

Practice location:
  • Phone: 301-540-0811
  • Fax: 301-540-0865
Mailing address:
  • Phone: 301-540-0811
  • Fax: 301-540-0865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0076735
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: