Provider Demographics
NPI:1427202050
Name:GREWAL, VIRINDER S (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRINDER
Middle Name:S
Last Name:GREWAL
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 1:2400 SCIENCE PKWY
Mailing Address - Street 2:2ND FLOOR, SUITE # 202
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-5506
Mailing Address - Country:US
Mailing Address - Phone:517-393-9300
Mailing Address - Fax:517-393-3003
Practice Address - Street 1:2400 SCIENCE PKWY
Practice Address - Street 2:2ND FLOOR, SUITE # 202
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-5506
Practice Address - Country:US
Practice Address - Phone:517-393-9300
Practice Address - Fax:517-393-3003
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301030430208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology