Provider Demographics
NPI:1922765122
Name:GREWAL, SAHIJ SINGH (OD)
Entity Type:Individual
Prefix:
First Name:SAHIJ
Middle Name:SINGH
Last Name:GREWAL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14887 SILENT BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-8308
Mailing Address - Country:US
Mailing Address - Phone:317-515-1277
Mailing Address - Fax:
Practice Address - Street 1:10777 E WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-2642
Practice Address - Country:US
Practice Address - Phone:317-897-0480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18004312B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist