Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 035275 | GA |
NPI | 1043267628 |
---|---|
Provider Name | Gurinderjit Kaur Sidhu |
First Address | Sandy Springs, GA 30342-1709 |
Second Address | Stockbridge, GA 30281-9250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 17/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00635214A | (05) | GA |
F76391 | (02) | GA |