Provider Demographics
NPI:1366648222
Name:SHERGILL, AJAINDER (DO, MBA)
Entity Type:Individual
Prefix:DR
First Name:AJAINDER
Middle Name:
Last Name:SHERGILL
Suffix:
Gender:M
Credentials:DO, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 CROW CANYON RD STE S360
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-1189
Mailing Address - Country:US
Mailing Address - Phone:360-334-1882
Mailing Address - Fax:
Practice Address - Street 1:2603 BRIDGEPORT WAY W STE F
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4724
Practice Address - Country:US
Practice Address - Phone:253-666-6780
Practice Address - Fax:253-666-6793
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60097497207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine