Provider Demographics
NPI:1356303366
Name:GILL, BALJIT SINGH (MD)
Entity Type:Individual
Prefix:
First Name:BALJIT
Middle Name:SINGH
Last Name:GILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:703 THIMBLE SHOALS BLVD
Mailing Address - Street 2:A3
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2576
Mailing Address - Country:US
Mailing Address - Phone:757-873-3401
Mailing Address - Fax:757-223-1165
Practice Address - Street 1:703 THIMBLE SHOALS BLVD
Practice Address - Street 2:A3
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2576
Practice Address - Country:US
Practice Address - Phone:757-873-3401
Practice Address - Fax:757-223-1165
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010368402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945301Medicaid
VA4945301Medicaid
VAE44120Medicare UPIN