Provider Demographics
NPI:1033521679
Name:SANDHU, JASPREET
Entity Type:Individual
Prefix:
First Name:JASPREET
Middle Name:
Last Name:SANDHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4252 AMARYLLIS DR APT E
Mailing Address - Street 2:
Mailing Address - City:SUGARCREEK TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7177
Mailing Address - Country:US
Mailing Address - Phone:614-354-1666
Mailing Address - Fax:
Practice Address - Street 1:3533 SOUTHERN BLVD STE 2100
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1267
Practice Address - Country:US
Practice Address - Phone:937-435-8663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.146535208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery