Healthcare Provider Details

I. General information

NPI: 1679532279
Provider Name (Legal Business Name): MAHESH S. SANDHU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MAHESH S SANDHU DO

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 BATTLEGROUND AVE
GREENSBORO NC
27410-2404
US

IV. Provider business mailing address

3402 BATTLEGROUND AVE
GREENSBORO NC
27410-2404
US

V. Phone/Fax

Practice location:
  • Phone: 336-545-1515
  • Fax: 336-545-4505
Mailing address:
  • Phone: 336-545-1515
  • Fax: 336-545-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS 008390L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberCA 20A6744
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2014-00296
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2014-00296
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number34007331
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number2014-00296
License Number StateNC
# 7
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34.007331
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: