Provider Demographics
NPI:1619927977
Name:SANDHU, IMRAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:K
Last Name:SANDHU
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 1:3824 NORTHERN PIKE
Mailing Address - Street 2:STE 700
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2141
Mailing Address - Country:US
Mailing Address - Phone:412-457-0060
Mailing Address - Fax:
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-7618
Practice Address - Fax:412-858-7628
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426459207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1800568OtherHIGHMARK BS PA
PA9765314OtherCIGNA
PA1015103330001Medicaid
PA1548761OtherGATEWAY HEALTH PLAN
PA000000178204OtherUNISON
PA711608OtherUPMC
PA1179729OtherAETNA
PA1179729OtherAETNA
PA098563Medicare ID - Type Unspecified