Provider Demographics
NPI:1225110992
Name:DOSANJH, GURSHARN SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:GURSHARN
Middle Name:SINGH
Last Name:DOSANJH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3181 PRAIRIE ST SW
Mailing Address - Street 2:SUITE 101 B
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-2097
Mailing Address - Country:US
Mailing Address - Phone:616-531-1871
Mailing Address - Fax:616-531-7323
Practice Address - Street 1:3181 PRAIRIE ST SW
Practice Address - Street 2:SUITE 101 B
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-2097
Practice Address - Country:US
Practice Address - Phone:616-531-1871
Practice Address - Fax:616-531-7323
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2010-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIGD046835207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIA76002Medicare UPIN