Provider Demographics
NPI:1396395992
Name:BRAR, SANDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:
Last Name:BRAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 88 AVENUE NE
Mailing Address - Street 2:
Mailing Address - City:CALGARY
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T3J 4C5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1403 29 STREET NW
Practice Address - Street 2:
Practice Address - City:CALGARY
Practice Address - State:ALBERTA
Practice Address - Zip Code:T2N 2T9
Practice Address - Country:CA
Practice Address - Phone:403-944-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA158583207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty