Provider Demographics
NPI:1750543518
Name:DHINDSA, GURKIRAN (MD)
Entity type:Individual
Prefix:DR
First Name:GURKIRAN
Middle Name:
Last Name:DHINDSA
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:PO BOX 411193
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-3193
Mailing Address - Country:US
Mailing Address - Phone:314-627-1627
Mailing Address - Fax:314-485-2374
Practice Address - Street 1:1023 EXECUTIVE PARKWAY DR STE 2
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6323
Practice Address - Country:US
Practice Address - Phone:314-627-1627
Practice Address - Fax:314-485-2374
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016025626207RE0101X
NY266359208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200037363Medicaid