Provider Demographics
NPI:1235318221
Name:DEOL, MANDEEP KAUR (MD)
Entity Type:Individual
Prefix:
First Name:MANDEEP
Middle Name:KAUR
Last Name:DEOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MANDEEP
Other - Middle Name:KAUR
Other - Last Name:DEOL AHUJA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2900 WEST OKLAHOMA AVENUE
Mailing Address - Street 2:AURORA FAMILY MEDICINE PROGRAM
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215
Mailing Address - Country:US
Mailing Address - Phone:414-649-6732
Mailing Address - Fax:414-649-5840
Practice Address - Street 1:2900 WEST OKLAHOMA AVENUE
Practice Address - Street 2:AURORA ST LUKES FAMILY MEDICINE PROGRAM
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215
Practice Address - Country:US
Practice Address - Phone:414-649-6732
Practice Address - Fax:414-649-5840
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program