Provider Demographics
NPI:1003892050
Name:PUREWAL, SUKHJIT SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUKHJIT
Middle Name:SINGH
Last Name:PUREWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29864 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-3522
Mailing Address - Country:US
Mailing Address - Phone:419-666-3765
Mailing Address - Fax:
Practice Address - Street 1:1011 SANDUSKY ST
Practice Address - Street 2:SUITE-C
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-3126
Practice Address - Country:US
Practice Address - Phone:419-874-9101
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-035641207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery