MEDICARE: DR. GURJEET SINGH KAHLON MD

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	35088496	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	9324321	OTHER	OH	VALLEY MEDICAL PRIMARY CARE GROUP MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1528127610	OTHER		VALLEY MEDICAL PRIMARY CARE INC- NPI #

General Provider Information

NPI Number	:	1649209644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GURJEET SINGH KAHLON MD

Provider Business Mailing Address
First Line	:	6611 CLYO RD
Second Line	:	SUITE E
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-2786
Country	:	US
Telephone Number	:	937-208-8282
Fax Number	:	937-208-8276

Provider Business Practice Location Address
First Line	:	6611 CLYO RD
Second Line	:	SUITE E
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-2786
Country	:	US
Telephone Number	:	937-208-8282
Fax Number	:	937-208-8276

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	09/23/2008

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