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General NPI Number Information
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NPI Number | 1053671529
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Entity Type | Individual
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Provider Name | TARANDEEP SINGH GREWAL MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 5443 W MOLLY LN
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City | PHOENIX
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State | AZ
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Zip | 85083-6376
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Country | US
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Telephone | 602-773-1120
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Fax |
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Provider Business Mailing Address
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Address Line | 5749 W PINNACLE HILL DR
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City | GLENDALE
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State | AZ
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Zip | 85310-3632
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Country | US
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Telephone |
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Fax | 480-478-6628
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT201636
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 50196
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 50196
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License Number State | AZ
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