Provider Demographics
NPI:1770666570
Name:SIDHU, DILBAGH SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:DILBAGH
Middle Name:SINGH
Last Name:SIDHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7839 ROLLING ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-2821
Mailing Address - Country:US
Mailing Address - Phone:703-569-6998
Mailing Address - Fax:703-569-7008
Practice Address - Street 1:7839 ROLLING ROAD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-2821
Practice Address - Country:US
Practice Address - Phone:703-569-6998
Practice Address - Fax:703-569-7008
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033011208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD05841Medicare UPIN