MEDICARE: LOVEKIRAT SINGH DHALIWAL

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
1	207R00000X	Internal Medicine Physician	110752	GA
2	207RG0100X	Gastroenterology Physician	110752	GA

General Provider Information

NPI Number	:	1205448594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOVEKIRAT SINGH DHALIWAL

Provider Business Mailing Address
First Line	:	100 WOODRUFF CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1020
Country	:	US
Telephone Number	:	507-779-2832
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 WOODRUFF CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1020
Country	:	US
Telephone Number	:	507-779-2832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2020
Last Update Date	:	03/16/2026

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