Healthcare Provider Details

I. General information

NPI: 1386712578
Provider Name (Legal Business Name): GURSHARANJIT SINGH DHILLON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 HAMPTON CIR SUITE 150
ROCHESTER HILLS MI
48307-4195
US

IV. Provider business mailing address

7045 TEN HL
WEST BLOOMFIELD MI
48322-4238
US

V. Phone/Fax

Practice location:
  • Phone: 248-853-9097
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number4301071426
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301071426
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: