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General NPI Number Information
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NPI Number | 1770102451
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Entity Type | Individual
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Provider Name | SARGUN SINGH WALIA
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Gender | Male
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 255 SMITH AVE N STE 100
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City | SAINT PAUL
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State | MN
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Zip | 55102-2518
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Country | US
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Telephone | 651-241-7246
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Fax | 651-241-7272
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-9000
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD-53065
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | 79178
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | MD-53065
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License Number State | IA
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