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General NPI Number Information
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NPI Number | 1215498373
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Entity Type | Individual
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Provider Name | SIMRATDEEP KAUR SANDHU
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Gender | Female
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 3200 MACCORKLE AVE SE FL 5 BEHAVIORAL MEDICINE AND PSYCHIATRY
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City | CHARLESTON
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State | WV
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Zip | 25304-1227
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Country | US
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Telephone | 304-388-1000
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Fax | 304-388-1041
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Provider Business Mailing Address
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Address Line | 1073 SARAH ST
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City | ALLEN
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State | TX
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Zip | 75013-2861
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Country | US
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Telephone | 469-601-8329
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101280579
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License Number State | VA
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