Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 0101270590 | VA |
N | 207RG0100X | Gastroenterologist | 55733-020 | WI |
NPI | 1043463185 |
---|---|
Provider Name | Amandeep Singh Kalra |
First Address | Fredericksburg, VA 22401-8425 |
Second Address | La Crosse, WI 54601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2008 |
Last Update Date | 17/09/2020 |