Provider Demographics
NPI:1689692550
Name:UPMA DHINGRA MD LLC
Entity Type:Organization
Organization Name:UPMA DHINGRA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UPMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DHINGRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-366-5600
Mailing Address - Street 1:25109 DETROIT RD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2551
Mailing Address - Country:US
Mailing Address - Phone:440-366-5600
Mailing Address - Fax:440-366-6766
Practice Address - Street 1:25109 DETROIT RD
Practice Address - Street 2:SUITE 325
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2551
Practice Address - Country:US
Practice Address - Phone:440-366-5600
Practice Address - Fax:440-366-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, GeropsychiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2449247Medicaid
OHDF1409OtherRAILROAD RETIRED MC
OH2449247Medicaid