Provider Demographics
NPI:1093276586
Name:SANDHU, JEENA KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:JEENA
Middle Name:KAUR
Last Name:SANDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:17471 WHEELER RD STE 114
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-6903
Practice Address - Country:US
Practice Address - Phone:317-912-1377
Practice Address - Fax:317-489-5830
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01090792A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology