Provider Demographics
NPI:1467025825
Name:DHALLA, PARAMVIJAY SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:PARAMVIJAY SINGH
Middle Name:
Last Name:DHALLA
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 1:2100 DOUGLAS ST APT 263
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1274
Mailing Address - Country:US
Mailing Address - Phone:402-619-7032
Mailing Address - Fax:
Practice Address - Street 1:7710 MERCY RD STE 202
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2353
Practice Address - Country:US
Practice Address - Phone:402-280-4318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NETEP9053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine