Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 0101031126 | VA |
Y | 207X00000X | Orthopaedic Surgeon | 0101031126 | VA |
NPI | 1073580221 |
---|---|
Provider Name | Baljit S Sidhu |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Prince George, VA 23875-1237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 05/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006408729 | (05) | VA |
1073580221 | MEDICARE RAILROAD (01) | VA |
B10299 | (02) | VA |