Provider Demographics
NPI:1013584994
Name:DHALLA, MOHSIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHSIN
Middle Name:
Last Name:DHALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 TOWER HILL ROAD
Mailing Address - Street 2:BOX 20075
Mailing Address - City:RICHMOND HILL
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L4E 0K9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1575 UPPER OTTAWA ST
Practice Address - Street 2:UNIT A5
Practice Address - City:HAMILTON
Practice Address - State:ONTARIO
Practice Address - Zip Code:L8W 3E2
Practice Address - Country:CA
Practice Address - Phone:416-844-9290
Practice Address - Fax:905-578-5779
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY308532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine