Provider Demographics
NPI:1851404123
Name:WADIA, GURJEET KAUR (MD)
Entity Type:Individual
Prefix:DR
First Name:GURJEET
Middle Name:KAUR
Last Name:WADIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 W 6TH ST STE 307
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4577
Mailing Address - Country:US
Mailing Address - Phone:775-329-6465
Mailing Address - Fax:775-329-5834
Practice Address - Street 1:236 W 6TH ST STE 307
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4577
Practice Address - Country:US
Practice Address - Phone:775-329-6465
Practice Address - Fax:775-329-5834
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4661208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20-16403Medicaid
NV31-16403Medicaid