Provider Demographics
NPI:1255327045
Name:BHALLA, HARPREET SINGH (MD)
Entity Type:Individual
Prefix:
First Name:HARPREET
Middle Name:SINGH
Last Name:BHALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 COURT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2134
Mailing Address - Country:US
Mailing Address - Phone:704-867-2141
Mailing Address - Fax:704-867-2308
Practice Address - Street 1:2555 COURT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2134
Practice Address - Country:US
Practice Address - Phone:704-867-2141
Practice Address - Fax:704-867-2308
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200000722207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00221800OtherRAILROAD MEDICARE
SCN00725Medicaid
NC891268MMedicaid
NC891268MMedicaid
NC2281036CMedicare PIN