Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 0101055410 | VA |
NPI | 1013992593 |
---|---|
Provider Name | Dr. Sarbjot Singh Dulai |
First Address | Leesburg, VA 20176-2704 |
Second Address | Lansdowne, VA 20176-8472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 12/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010050227 | (05) | VA |
102832 | ANTHEM (01) | VA |
G01850N01 | MEDICARE (01) | DC |
G74098 | (02) | |
J5450001 | BLUE CROSS BLUE SHIELD (01) | DC |
P00184236 | MEDICARE RR (01) |