Provider Demographics
NPI:1992833206
Name:SOHAL, SANDEEP S (MD)
Entity Type:Individual
Prefix:MR
First Name:SANDEEP
Middle Name:S
Last Name:SOHAL
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 1:2011 MIDDLEBELT ROAD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135
Mailing Address - Country:US
Mailing Address - Phone:734-367-1205
Mailing Address - Fax:734-367-1214
Practice Address - Street 1:2011 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2819
Practice Address - Country:US
Practice Address - Phone:734-367-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082094208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice