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General NPI Number Information
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NPI Number | 1669660023
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Entity Type | Organization
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Legal Business Name | GURSEWAK S. SANDHU, MD, PC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 511 W GROVE ST SUITE 301
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City | MIDDLEBORO
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State | MA
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Zip | 02346-1458
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Country | US
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Telephone | 508-947-4634
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Fax | 508-947-0635
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Provider Business Mailing Address
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Address Line | 511 W GROVE ST SUITE 301
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City | MIDDLEBORO
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State | MA
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Zip | 02346-1458
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Country | US
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Telephone | 508-947-4634
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Fax | 508-947-0635
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Authorized Official
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Title or Position | OWNER
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Name | DR. GURSEWAK S SANDHU
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Credential | M.D.
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Telephone | 508-947-4634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 44829
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License Number State | MA
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