Healthcare Provider Details

I. General information

NPI: 1598342115
Provider Name (Legal Business Name): GUNDIP SINGH DHILLON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2021
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27472 SCHOENHERR RD STE 100
WARREN MI
48088-6675
US

IV. Provider business mailing address

27472 SCHOENHERR RD STE 100
WARREN MI
48088-6675
US

V. Phone/Fax

Practice location:
  • Phone: 586-751-8844
  • Fax:
Mailing address:
  • Phone: 586-751-8844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5151016960
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: