Provider Demographics
NPI:1417114901
Name:DHILLON, WISHWDEEP SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:WISHWDEEP
Middle Name:SINGH
Last Name:DHILLON
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 1:3645 S ROME ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-7336
Mailing Address - Country:US
Mailing Address - Phone:480-270-6277
Mailing Address - Fax:480-634-2313
Practice Address - Street 1:3645 S ROME ST
Practice Address - Street 2:SUITE 116
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7336
Practice Address - Country:US
Practice Address - Phone:480-270-6277
Practice Address - Fax:480-634-2313
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440373207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program