Provider Demographics
NPI:1639195423
Name:SANDHU, AMANPREET S (MD)
Entity Type:Individual
Prefix:
First Name:AMANPREET
Middle Name:S
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 1:8012 BRETZ DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-9748
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2005 TECHNOLOGY PKWY STE 245
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9413
Practice Address - Country:US
Practice Address - Phone:717-791-2850
Practice Address - Fax:717-221-5275
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445968207R00000X, 207L00000X, 207LP2900X
CT040624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102725805 0003Medicaid
PA102725805 0002Medicaid
PA8535447OtherAETNA HMO
PAP010711315OtherRAILROAD MEDICARE
PA002710431OtherHIGHMARK BLUE SHIELD
PA102725805 0001Medicaid
CT001406249Medicaid
PA8535449OtherAETNA HMO
PA7983795OtherAETNA NON HMO
CT001406249Medicaid
PA7983795OtherAETNA NON HMO
PA102725805 0001Medicaid