Healthcare Provider Details

I. General information

NPI: 1851234793
Provider Name (Legal Business Name): PANJ AAB NEUROVASCULAR ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 E 1ST ST
DULUTH MN
55805-2107
US

IV. Provider business mailing address

5013 S LOUISE AVE UNIT 911
SIOUX FALLS SD
57108-2268
US

V. Phone/Fax

Practice location:
  • Phone: 573-529-7510
  • Fax: 573-529-7510
Mailing address:
  • Phone: 573-529-7510
  • Fax: 573-529-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DIVYAJOT SINGH SANDHU
Title or Position: DIRECTOR
Credential: MD
Phone: 573-529-7510