Healthcare Provider Details

I. General information

NPI: 1043686306
Provider Name (Legal Business Name): HERMAN SINGH DHOTAR M.D. FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 SHEPPARD AVE E SUITE 243
TORONTO ONTARIO
M2J1V1
CA

IV. Provider business mailing address

1333 SHEPPARD AVE E SUITE 243
TORONTO ONTARIO
M2J1V1
CA

V. Phone/Fax

Practice location:
  • Phone: 416-494-7351
  • Fax: 416-494-7446
Mailing address:
  • Phone: 416-494-7351
  • Fax: 416-494-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number210335
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: