Provider Demographics
NPI:1306226238
Name:DHILLON, MANINDERPAL SINGH (DO)
Entity Type:Individual
Prefix:
First Name:MANINDERPAL
Middle Name:SINGH
Last Name:DHILLON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:965 FEE RD
Mailing Address - Street 2:ROOM A233
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-6410
Mailing Address - Country:US
Mailing Address - Phone:517-353-3070
Mailing Address - Fax:517-432-3603
Practice Address - Street 1:965 FEE RD
Practice Address - Street 2:ROOM A233
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-6410
Practice Address - Country:US
Practice Address - Phone:517-353-3070
Practice Address - Fax:517-432-3603
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010216632084P0800X
MI53150699222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry