MEDICARE: DR. VERINDER SINGH SIDHU 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	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	LT000941	PA

General Provider Information

NPI Number	:	1972239051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERINDER SINGH SIDHU MD

Provider Business Mailing Address
First Line	:	2200 BENJAMIN FRANKLIN PKWY APT N1804
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3721
Country	:	US
Telephone Number	:	484-388-3371
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 S 11TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4824
Country	:	US
Telephone Number	:	267-297-2440
Fax Number	:

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

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	07/29/2022

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