Provider Demographics
NPI:1083702799
Name:KAUR, HARMINDER (MD)
Entity Type:Individual
Prefix:
First Name:HARMINDER
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23208 BREWERS TAVERN WAY
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4391
Mailing Address - Country:US
Mailing Address - Phone:301-515-3333
Mailing Address - Fax:301-515-3322
Practice Address - Street 1:186 THOMAS JOHNSON DR
Practice Address - Street 2:105
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702
Practice Address - Country:US
Practice Address - Phone:301-515-3333
Practice Address - Fax:301-515-3322
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058497207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403556900Medicaid
DC09670001OtherCAREFIRST BCBS
MD403556900Medicaid
F98387Medicare UPIN
DCG02790C01Medicare PIN