Provider Demographics
NPI:1750464921
Name:DHILLON, GURSHEEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:GURSHEEL
Middle Name:S
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 1:2144 DECHERD BLVD
Mailing Address - Street 2:
Mailing Address - City:DECHERD
Mailing Address - State:TN
Mailing Address - Zip Code:37324
Mailing Address - Country:US
Mailing Address - Phone:931-962-3522
Mailing Address - Fax:931-962-3523
Practice Address - Street 1:2144 DECHERD BLVD
Practice Address - Street 2:
Practice Address - City:DECHERD
Practice Address - State:TN
Practice Address - Zip Code:37324
Practice Address - Country:US
Practice Address - Phone:931-962-3522
Practice Address - Fax:931-962-3523
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000031600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3849183Medicaid
H09455Medicare UPIN
TN3849183Medicaid