Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 4301071426 | MI |
N | 208000000X | Pediatrician | 4301071426 | MI |
NPI | 1386712578 |
---|---|
Provider Name | Gursharanjit Singh Dhillon |
First Address | West Bloomfield, MI 48322-4238 |
Second Address | Rochester Hills, MI 48307-4195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 27/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4507606 | (05) | MI |
H53989 | (02) | MI |