Provider Demographics
NPI:1780868315
Name:SANDEEP S SOHAL MD PC
Entity Type:Organization
Organization Name:SANDEEP S SOHAL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-281-5349
Mailing Address - Street 1:24131 PHEASANT RUN
Mailing Address - Street 2:#204
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-3382
Mailing Address - Country:US
Mailing Address - Phone:517-281-5349
Mailing Address - Fax:248-489-4503
Practice Address - Street 1:24131 PHEASANT RUN
Practice Address - Street 2:#204
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-3382
Practice Address - Country:US
Practice Address - Phone:517-281-5349
Practice Address - Fax:248-489-4503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty