Healthcare Provider Details

I. General information

NPI: 1659829265
Provider Name (Legal Business Name): BHUPINDER SINGH MULTANI FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BHUPINDER SINGH MULTANI FNP

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MILLER ST STE C
WINSTON SALEM NC
27104-4206
US

IV. Provider business mailing address

PO BOX 601843
CHARLOTTE NC
28260-1843
US

V. Phone/Fax

Practice location:
  • Phone: 336-310-5535
  • Fax: 336-310-1183
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF340910-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP8971
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5009487
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5009487
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: