Healthcare Provider Details

I. General information

NPI: 1225151236
Provider Name (Legal Business Name): SANTOKH SINGH DHILLON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SPARROW HOSPITAL 901, EAST MT. HOPE AVE
LANSING MI
48910
US

IV. Provider business mailing address

5400 MALL DR W APT #3107
LANSING MI
48917-3260
US

V. Phone/Fax

Practice location:
  • Phone: 517-485-1153
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301087677
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: