Provider Demographics
NPI:1619167483
Name:DHILLON, RUPINDERJIT SINGH (MD)
Entity Type:Individual
Prefix:
First Name:RUPINDERJIT
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 1:11550 OLIVE BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7111
Mailing Address - Country:US
Mailing Address - Phone:314-205-8344
Mailing Address - Fax:314-590-5931
Practice Address - Street 1:11550 OLIVE BLVD
Practice Address - Street 2:STE 140
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7111
Practice Address - Country:US
Practice Address - Phone:314-205-8344
Practice Address - Fax:314-590-5931
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-50501207R00000X, 208M00000X
LAMD.203869208M00000X
MO2015001549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05374052Medicaid
LA1000671Medicaid
LA1000673Medicaid
MS05374052Medicaid
LA1000671Medicaid