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General NPI Number Information
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NPI Number | 1699255935
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Entity Type | Organization
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Legal Business Name | WEST COUNTY DIABETES AND ENDOCRINOLOGY CENTER PC
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1023 EXECUTIVE PARKWAY DR STE 2
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City | CREVE COEUR
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State | MO
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Zip | 63141-6323
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Country | US
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Telephone | 314-627-1627
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Fax | 314-485-2374
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Provider Business Mailing Address
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Address Line | PO BOX 411193
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City | CREVE COEUR
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State | MO
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Zip | 63141-3193
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Country | US
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Telephone | 314-627-1627
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Fax | 314-485-2374
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | GURKIRAN DHINDSA
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Credential | MD
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Telephone | 716-598-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 2016025626
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License Number State | MO
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