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NPI Code Detail

MEDICARE: GURVINDER SINGH DHALIWAL M.D.

MEDICARE: GURVINDER SINGH DHALIWAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician65694AZ

General Provider Information

NPI Number : 1174979330
Entity Type Code : Individual
Provider Name (Legal Business Name) : GURVINDER SINGH DHALIWAL M.D.
Provider Business Mailing Address
First Line : 13995 W STATLER BLVD
Second Line :
City : SURPRISE
State : AZ
Zip : 85374-5501
Country : US
Telephone Number : 623-478-3100
Fax Number : 623-478-3300
Provider Business Practice Location Address
First Line : 13995 W STATLER BLVD STE 200
Second Line :
City : SURPRISE
State : AZ
Zip : 85374-5503
Country : US
Telephone Number : 623-478-3100
Fax Number : 623-478-3300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2016
Last Update Date : 08/29/2024

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